Cleft and craniofacial conditions affect thousands of infants, children, teens, and adults in the United States each year. Some are born with congenital anomalies like cleft lip and palate, others with more complex, life-threatening craniofacial conditions. Despite extensive research about cleft lip and palate, its causes are still unknown.
Cleft lip and cleft palate occur when a baby’s lip or mouth do not form properly during pregnancy. Craniofacial birth defects are those that present as malformations to the face or head with or without a cleft of the lip or palate. According to the World Health Organization these conditions combined are the number one recorded birth defect worldwide. In the United States, approximately one of every 600 to 1,000 births will result in cleft lip or palate and one of 10,000 births will present with craniofacial malformations.
Though rare, children born with these conditions can face numerous challenges because of structural differences of the mouth, lips, face, and external head. Infants, for example, will have difficulty feeding due to the inability to achieve suction during nursing because of the cleft or opening in their palate. The malalignment of teeth and jaws can also result in breathing, hearing, seeing, and speaking difficulties during childhood and later years.
The good news is that numerous medical, surgical, and therapeutic options are available to improve and alleviate these conditions. Although there are many challenges for children affected by cleft and craniofacial conditions, the prognosis for successful treatment and the ability to live normally is excellent.
Treatment of these conditions often includes plastic surgery, advanced medical and dental care, ongoing speech and audiology evaluations, as well as psychosocial support for families. For most families, special maternal and child health legislation passed in the 1930s enables most children in the United States to receive the basic rehabilitative care needed regardless of their family’s ability to pay for it.
Today, the evaluation and treatment planning for individuals with a cleft or craniofacial condition may begin in the prenatal period, as facial birth defects are often seen on prenatal ultrasounds, and generally will last until facial maturity is reached in the late teens or early twenties. Although the rehabilitative process may take several years, the end result is usually an excellent one.
Martha S. Matthews, MD, FACS
Medical Director, Cleft and Craniofacial Program
Cooper University Health Care