What is a cleft palate/lip?

A cleft palate/lip occurs when parts of the lip or palate do not completely fuse together during the first three Cleft Palate/Lipmonths of pregnancy. Cleft palates and cleft lips vary in size. For example, if a child has a cleft palate, the defect may only affect the soft palate, or it may be a complete cleft that involves the hard palate. The palate and lips develop separately, therefore, a child may have a cleft lip only, a cleft palate only or both. Furthermore, it can occur on one side of the mouth, known as unilateral clefting, or it may occur on both sides which is known as bilateral clefting.

What causes a cleft palate/lip?

A cleft palate/lip can be caused by a number of different things. Most often, the cause is not known and can not be determined. A cleft palate/lip can be genetic and therefore run in families. It could also occur as part of a syndrome, which means that there are other birth defects in other parts of the body. It may also be the result of environmental factors including the use of medication during pregnancy, exposure to cigarette smoke or a lack of vitamins during pregnancy. A cleft palate/lip is usually diagnosed right after the baby is born.

How can I help treat my child’s condition?

A number of different professionals may be involved in the treatment and care of a cleft palate/lip. The following are some of the professionals who may be involved:

  • geneticist
  • pediatrician
  • plastic surgeon
  • ear, nose, and throat physician (otolaryngologist)
  • oral surgeon
  • orthodontist
  • dentist
  • speech-language pathologist
  • audiologist
  • nurse
  • social worker
  • psychologist
  • team coordinator

A speech-language pathologist is responsible for working with children whose cleft palate/lip causes speech or feeding problems. The most common speech problem for children with a cleft palate is hypernasality. This occurs because the palate is unable to close off the nose from the mouth, thus air escapes from the nose. The child will sound like he/she is talking out of his nose, rather than out of his/her mouth. Children with a cleft palate/lip may also have an articulation disorder or speech delay.

Feeding problems are greater and more common in children with a cleft palate, as compared to those with a cleft lip. The palate is responsible for keeping food and liquid from entering the nose. If the palate is not intact, the baby will have a difficult time sucking a regular nipple. As a result, a special nipple and bottle will be used, in addition to certain positioning of the baby.

Our Approach at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our therapists will begin by completing a thorough evaluation. After the evaluation, the therapists will use an approach that is appropriate to the speech-language problem. Speech therapy can help improve the hypernasality, articulation problems or speech delay.