Why Cleft Lip Occurs ? - Risk Factor & Prevention

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Cleft lip or hare lip is the second common birth defect affecting  humans. This happens due to the incomplete formation of the lip/palate  during the first few weeks of pregnancy. A cleft is a lack of  continuity. When its there on the upper lip on one side, it’s called the  unilateral cleft lip. When it’s on both the sides, it’s called the  bilateral cleft lip. Likewise, when there is a gap in the hard palate  and /or the soft palate, it’s called a cleft palate. Again, it could be  unilateral (one-sided) or bilateral (two-sided). Genetics plays an  important factor. 

A cleft lip happens if the tissue that makes up the lip does not join completely before birth. This results in an opening in the upper lip. The opening in the lip can be a small slit or it can be a large opening that goes through the lip into the nose


It is generally believed that about 1 in every 700 live births is born  with a cleft lip or palate. India has a huge population of 1.35 Billion  people, with the second most populous nation in the world. Therefore,  India also has a huge number of kids born with cleft lip and palate. It  is estimated that around 30,000 kids are born with clefts every year.  According to the World Health Organization, this accounts for nearly  half of all craniofacial deformities. 

 Cleft lip and cleft palate occur when tissues in the baby's face and  mouth don't fuse properly. Normally, the tissues that make up the lip  and palate fuse together in the second and third months of pregnancy.  But in babies with cleft lip and cleft palate, the fusion never takes  place or occurs only part way, leaving an opening (cleft).

Researchers believe that most cases of cleft lip and cleft palate are  caused by an interaction of genetic and environmental factors. In many  babies, a definite cause isn't discovered.

The mother or the father can pass on genes that cause clefting,  either alone or as part of a genetic syndrome that includes a cleft lip  or cleft palate as one of its signs. In some cases, babies inherit a  gene that makes them more likely to develop a cleft, and then an  environmental trigger actually causes the cleft to occur.

Several factors may increase the likelihood of a baby developing a cleft lip and cleft palate, including:

• Family history. Parents with a family history of cleft lip or cleft palate face a higher risk of having a baby with a cleft.
• Exposure to certain substances during pregnancy. Cleft lip and cleft palate may be more likely to occur in pregnant  women who smoke cigarettes, drink alcohol or take certain medications.
• Having diabetes. There is some evidence that  women diagnosed with diabetes before pregnancy may have an increased  risk of having a baby with a cleft lip with or without a cleft palate.
• Being obese during pregnancy. There is some evidence that babies born to obese women may have increased risk of cleft lip and palate.

Males are more likely to have a cleft lip with or without cleft  palate. Cleft palate without cleft lip is more common in females. 

 In children with cleft lip and cleft palate, depending on the severity of deformation, various problems are encountered.

In the absence of separation in the palate,  liquids and food can enter into the nose from the mouth. Specially  designed feeding bottles with nipples are now available to stop fluids  and food flowing back into the nose. Even manmade palates are available  to help these children with cleft palate to feed properly until proper  surgical treatment is provided.

Fluid buildup can occur in children with cleft  palate making them more prone to middle ear infections. If these  infections can cause loss of hearing if not treated. To aid regular  fluid drainage from the middle ear, special tubes are needed to be  placed in the ear drums. These children need regular exam at least once a  year to check for any ear problems.

Children with cleft palate may face problems in  their speech as their sounds are not carried on well and may take on a  nasal pitch. In most the children surgery can fix this problem and in  some children, assistance of speech pathologist may be needed who can  work with these children to resolve the problems.

Children with clefts are more inclined to suffer  from dental problems due to malformed, missing, extra or misplaced  teeth.  In addition, children with cleft palate are likely to have  defective bony upper gum part that holds the teeth. This defect may  prevent proper development of the upper ridge, displace and rotate  permanent teeth and hider the appearance of teeth. Most of these  problems can be corrected through surgery.

Due to differences in the appearance from the  normal children and also because of the stress from the intensive  medical treatment, these children with clefts may experience social,  behavioral and emotional problems. A psychologist or social worker can  help your child, you and your family to overcome these difficulties.

After a baby is born with a cleft, parents are understandably  concerned about the possibility of having another child with the same  condition. While many cases of cleft lip and cleft palate can't be  prevented, consider these steps to increase your understanding or lower  your risk:

• Consider genetic counseling. If you have a  family history of cleft lip and cleft palate, tell your doctor before  you become pregnant. Your doctor may refer you to a genetic counselor  who can help determine your risk of having children with cleft lip and  cleft palate.

• Take prenatal vitamins. If you're planning to get pregnant soon, ask your doctor if you should take prenatal vitamins.

• Don't use tobacco or alcohol. Use of alcohol or tobacco during pregnancy increases the risk of having a baby with a birth defect