PASAGI, Ayessah Nesreen B.

pasagi.ab147@s.msumain.edu.ph
BA ELS - 1

CLEFT
Cleft is a birth defect that occurs when a baby’s lip or mouth does not
form properly during pregnancy.
 A cleft lip “is a split, or cleft, in the
skin of the upper lip. This defect can
range in size from a tiny, almost
imperceptible hole to a very large
opening that includes the top gum and
top jaw.”
 A cleft palate “is an opening in the
roof of the mouth. This opening can go
through the bony hard palate around
the top row of teeth; through the fleshy
soft palate at the back of the mouth; or
through both parts.”
 Cleft lip and cleft palate, together, are
commonly referred to as orofacial clefts.

Types of Clefts
Cleft can present several challenges for a child, including possible:
 Feeding issues
 Dental and orthodontic problems
 Speech and language difficulties
 Hearing impairment
 Social and self-esteem challenges

Diagnosis
Cleft can be diagnosed during pregnancy by a routine ultrasound. It
can also be diagnosed after the child is born, especially cleft palate.
However, sometimes particular types of cleft palate might not be diagnosed
until later in life.

Causes of Cleft
During pregnancy, cleft may be developed because the mother may be
involved in the following:
 Taking certain medications
 Tobacco or alcohol consumption
 Vitamin deficiency
 Viral illness
Some children with cleft have other family members with the defect, but
in most cases, there is no evidence of any family history. In rare cases, a
child’s cleft may be related to a syndrome such as Van der Woude
syndrome, Stickler syndrome, or Kabuki syndrome.
Management and Treatment
Orofacial Cleft
Surgical treatments and other services for children with orofacial cleft
can vary depending on the severity of the defect. Specialists consider the
child’s age and needs, presence of associated syndromes or other birth
defects, or both. Children may also need special treatments and services,
such as special dental or orthodontic care, or speech therapy.
Cleft Lip
Surgical treatment for children with cleft lip usually occurs in the first
few months of life and is recommended within the first 12 months of life, if
possible.
Cleft Palate
Surgical treatment for children with cleft palate is recommended within
the first 18 months of life or earlier if possible. Many children will need
additional surgical procedures as they get older.
Surgical repair can improve the look and appearance of a child’s face
and might also improve breathing, hearing, and speech and language
development.

Sample Case
Joshua Aiden was born with an orofacial cleft. Other than the fact that
he looked a little different, he was just like any other healthy child. He had
his first surgery when he was just 3-month-old. Surgeons repaired his lip
and after the surgery, he looked well. However, after only three days, the
sutures started coming out and his lip reopened. Joshua had over 14
heartbreaking surgeries over the next three years. His palate repair healed
as planned, but not his lip.
You may read the story of how Joshua’s cleft was treated, as originally
written by his mother:
Our miracle started at the mall, while taking Joshua’s birthday
pictures. A professional baseball player named Mike Adams approached us
about Joshua and asked why his lip had not been repaired. When we
explained our situation, he asked if he could help us. Because of this, Joshua
received a special surgery using a technique that had not been used on
Joshua before, and this time the lip did not come apart. This has completely
changed Joshua’s life and ours. As parents and grandparents, it was hard to
watch Joshua undergo so many surgeries and procedures. We only wanted
Joshua to be healed and start living his life without being stared or laughed
at. The first time Joshua was able to drink from a straw or even blow
bubbles came just a couple of months ago. And yes, I cried tears of joy,
because he was so excited that he could drink from a straw. He said “Look
NaNa, I can do it. I can really do it. I am drinking from my straw.” These are
just a couple of things you would not consider important until you see all of
your friends and classmates doing it and knowing that you can’t. Today
Joshua can drink from a straw, blow bubbles, kiss and most of all – smile.
Joshua will have a few more surgeries in his future, but this was the one
that has changed him forever.

References:
https://www.childrenshospital.org/conditions-and-treatments/conditions/c/
cleft-lip-and-cleft-palate/symptoms-and-causes
https://www.cdc.gov/ncbddd/birthdefects/cleftlip
https://www.cdc.gov/ncbddd/birthdefects/stories/cleft-lip/Joshua
http://www.msrblog.com/science/medical/cleft-lip-and-cleft-palate-
diagnosis-treatment-and-preventions