What is a cleft lip?
A cleft lip occurs when tissues of the lip and bone of the upper jaw fail to fuse during early development of the fetus. This process takes place during the 4th and 6th week of gestation. The condition can vary from a small notch in the red part of the lip (Fig. 2) to a wide gap in the lip and gumline extending into the nostril of the nose (Fig. 3). A cleft lip may occur on the left side, the right side, or both sides (Fig. 4). Cleft lip surgery is required to repair a cleft lip.
Fig. 1 – Normal lip
Fig. 2 – Small incomplete cleft lip
Fig. 3 – Complete unilateral cleft lip
Fig. 4 – Bilateral cleft lip
How common are cleft lips?
Roughly 1 out of every 1000 children are born with a cleft lip. About 70% of these children will also have a cleft palate. The other one third will have only a cleft lip. Cleft lip is more common in certain ethnic groups (including Asians, Lations, and Native Americans) and less common in others (Africans and African Americans).
What causes a cleft lip?
Despite years of research we still do not have a great understanding of why cleft lip occur. Most doctors and scientists agree that clefts are a combination of genetic as well as environmental factors including drugs, infections, maternal illness, and possibly vitamin deficiencies.
There is recent medical evidence to suggest that mothers with diets rich in folic acid (fruits, vegetables, and other high folate containing foods) who take folic acid supplements during pregnancy have a lower risk of having a baby with a cleft lip.
Some children with cleft lip may also have other congenital differences. These can range from easily recognized conditions to ones that are more difficult to detect. However, most children born with a cleft lip and/or palate are otherwise typically developing, healthy children.
How do I feed my child with a cleft lip?
Feeding may be different for babies born with a cleft lip. Every baby’s needs are different, so it is important to talk with your doctor or feeding specialist about the best feeding approach for your child. If you are having difficulty feeding your baby or have questions about feeding at home, please call our office. Our care team can provide guidance and support.
How is a cleft lip repaired?
The repair of a cleft lip requires surgery and general anesthesia. Many different techniques have been developed over the years to repair cleft lips. Different techniques are appropriate for different kinds of cleft lips. Your doctor will select the type of corrective surgery that is most appropriate for your child’s cleft.
When is the right time for cleft lip surgery?
In most cases, cleft lip surgery is performed when a baby is at least 8 to 12 weeks old.
Several factors are considered when determining the best time to repair a cleft lip. These include a baby’s birth history, gestational age, overall health, growth and development, feeding patterns, pain management needs, parent preferences and family circumstances. Our ENT surgeons, primary care providers, and families work together to determine the most appropriate timing for surgery.
There is no medical need to rush cleft lip repair. A cleft lip does not cause pain for a baby, and feeding difficulties before surgery do not necessarily improve after repair. The cosmetic outcome of cleft lip surgery is not affected by the timing of the procedure.
Are there any instructions I need to follow before cleft lip surgery?
Your child must have a physical examination by their pediatrician or family doctor within 7 days before surgery to make sure they are in good health. The doctor you see needs to complete the History and Physical form provided by our office. You must bring the completed form with you the day of surgery.
For your child’s safety, it is very important that they have an empty stomach when anesthesia is given. Please follow our preoperative eating and drinking guidelines. If you do not follow these guidelines, your child’s surgery will be cancelled.
What can I expect after surgery?
Cleft lip repair surgery usually takes between 2 and 3 hours. Your doctor will speak with you as soon as the surgery is complete.
After surgery, your child will wake up in the recovery room, which may take 45 minutes to an hour. Once awake, your child will be admitted to the hospital. You may accompany your child when they are transferred to your hospital room. One or both parents may stay with their child throughout the hospital stay, and we encourage at least one parent to remain with their child during hospitalization.
Following surgery, your child will have soft arm splints in place. These splints help prevent hands or objects from being placed in the mouth while the lip heals. The splints may be removed while you are holding your child and can closely supervise them. At all other times, the arm splints should be worn for two weeks after surgery.
Most children are discharged from the hospital after one night. In some cases, a child may need a longer hospital stay if there are feeding concerns or additional time is needed for pain control.
Where to find cleft lip surgery treatment?
Cleft lip surgery is provided by our ENT and facial plastic surgery team at Children’s Minnesota. Care is available at our Minneapolis and St. Paul campuses.
To schedule a consultation, please call: 612-874-1292.
Questions?
This information is not specific to your child and provides general information. If you have any questions, please call your nearest Children’s Minensota ENT and facial plastic surgery clinic.
