Causes of cleft lip in babies and their risk factors

Every parent certainly dreams of a baby born in a healthy and perfect condition. However, sometimes there are babies who experience birth defects such as cleft lip. Moreover, the problem of cleft lip in Indonesia continues to occur. Check out a complete explanation of the causes, symptoms, and treatments that can be done for cleft lip conditions in babies.

What is a cleft lip?

Cleft lip or cleft lip is a deformity that can occur on one or both sides of the mouth.

This condition begins before birth or since the development of the baby is still in the womb.

Cleft lip occurs when the tissues that make up the lips and palate fail to fully fuse together.

This results in the formation of a gap or split in the upper lip, aka the roof of the mouth.

Defects can be genetic or the result of exposure to the environment during pregnancy.

The most common feature of a cleft lip is a cleft that divides the sides of the upper lip and extends up to the nose.

As a result, babies with cleft lip conditions will find it difficult to swallow and speak like other normal babies.

Is this condition common?

Cleft lip is one of the most common forms of birth defects.

It is estimated that among 700 births, one of them has a cleft lip and palate.

According to the Indonesian Ministry of Health's Data Center, the percentage of children with cleft lip and palate reached 20.4% from 2014-2018.

The incidence rate is mostly found in male sex than female.

The risk of a parent with a child with a cleft lip to have another child with the same condition is 4%.

What are the signs and symptoms of cleft lip?

Generally, these conditions are immediately visible at birth and have their respective types, such as:

Cleft lips that can affect one or both sides of the face.
Slit lips that can be seen as an incision on the lip.
The fissures also range from the lips through the upper gums and palate to the lower part of the nose.
A cleft in the roof of the mouth that does not affect the appearance of the face.

Sometimes, the cleft occurs only in the muscle of the soft palate (cleft in the submucosal palate).

This gap is located at the back of the mouth and is covered by the lining of the mouth.

However, it should be noted that the type of cleft in the roof of the mouth is often not detected at birth.

It may be difficult to diagnose until symptoms appear, such as:

Difficulty swallowing
Voice speaking from the nose (nasal voice)
Recurrent ear infections

What causes cleft lip?

According to the Centers for Disease Control and Prevention (CDC), cleft lip occurs because the baby's face and mouth are not properly formed from the time they are still in the womb.

Ideally, the tissues that make up the lips and palate will fuse in the second and third months of pregnancy.

Here are various causes of cleft lip in babies, such as:

1. Genetic factors

Launching from the Mayo Clinic page, in most cases, genetic factors are believed to play a big role in causing cleft lip.

Yes, parents or siblings may inherit the gene that triggers the onset of cleft lip.

The more family members who experience it, the more likely you are to give birth to a baby with this congenital defect.

2. Environmental and lifestyle factors

Apart from heredity, other things that also cause cleft lip in babies are environmental factors.

For example, pregnant women who are exposed to chemicals and viruses have a greater chance of giving birth to a baby with a cleft lip.

This is because exposure has an effect on the growth and development of your little one while in the womb.

Not only that, nutritional deficiencies during pregnancy also affect the baby's condition later.

On the other hand, the habit of drinking alcohol and consuming illegal drugs also has the potential to cause cleft lip in babies.

Other factors that increase the risk

Cleft lip is a condition that can be suffered by anyone. Apart from the causes above, there are also factors that increase the risk, such as:

1. Take medication during pregnancy

Drug consumption during pregnancy also affects the baby's condition at birth.

There are several drugs that are allegedly at risk of causing a cleft in the lips, namely:

Acne medications such as accutane.
Anti-seizure or epilepsy drugs

The use of these drugs is at risk of causing cleft palate of the baby.

Meanwhile, for pregnant women who do not take these drugs, the risk is certainly much smaller.

2. Smoking during pregnancy

In fact, smoking during pregnancy has a greater chance of giving birth to babies with congenital birth defects, such as cleft lip.

This is because cigarette smoke is exposure to harmful substances, including during pregnancy.

3. Experiencing diabetes while pregnant

The chances of giving birth to a baby with this condition in pregnant women who have a history of diabetes are also higher.

Some experts believe that women who are diagnosed with diabetes before becoming pregnant may have an increased risk of developing cleft lip.

4. Being overweight during pregnancy

Women who are planning a pregnancy are advised to pay more attention to their ideal weight before becoming pregnant.

This is because excess weight during pregnancy can be one of the risks that causes babies to be born with cleft lip and palate.

What are the complications of cleft lip?

Children who have cleft lips will face several challenges in life.

However, this depends on the type and severity of the condition. Here are some complications from cleft lip conditions:

1. Difficulty eating

One of the problems to worry about after birth with this condition is how to eat.

Most babies with cleft lip can still breastfeed, but this is more difficult for babies with cleft palates.

This then becomes one of the factors for babies to have difficulty eating.

2. Ear infection

Babies born with this condition have a risk of more ear fluid than normal.

That way, you are likely to have an infection so that your hearing is impaired.

3. Problems with teeth

If the cleft or cleft extends to the upper gum, the baby's teething may experience some problems.

4. Difficulty speaking

It should be noted that if the baby has a cleft lip, the shape is different from what it should be.

Therefore, this difference does not rule out the possibility that the child will have difficulty speaking normally.

5. Susceptible to stress

Children who have this condition may experience social, emotional, and behavioral problems.

This can happen because they often undergo different kinds of intensive care.

In addition, children can also experience insecurity because they feel different from other normal children.

Handling that can be done

There are several treatments that can be done to treat cleft lip in children.

This depends on the severity of the gap, age, and whether there are other birth defect syndromes.

Therefore, the treatment that is generally carried out by doctors is cleft lip surgery.

This surgery is recommended to be performed in the first 12 months of the baby's age.

The following is the sequence of cleft lip surgery procedures performed:

1. Explanation to parents

2. Age 3 months: Lip surgery and analasi, ear evaluation (provided that the weight reaches 5 kilograms)

3. Age 10-12 months: Palato or cleft palate surgery and evaluation of hearing and ears

4. Ages 1-4 years: Evaluation of speech and speech therapy after three months postoperatively

5. Age 4 years: Considered repalatoraphy or pharyngoplasty

6. Age 6 years: Evaluate teeth and jaw and evaluate hearing

7. 9-10 years old: Alveolar bone graft or alveolar bone graft. Surgery to add bone to the gums in children.

8. Age 12-13 years: Other improvements if needed

9. Age 17 years: Evaluate facial bones

Do speech therapy

In addition to surgical procedures, speech therapy is also needed for children who experience cleft lip.

The reason is, cleft lip patients are not only having difficulty eating. They also have difficulty speaking properly.

This condition causes the cleft lip patient to have difficulty pronouncing consonants, such as the letters B, D, G, and K.

This therapy can be done in children from 18 months to 5 years of age. This is because the child's speech ability is developing.

Not only with therapists, parents are also expected to help children practice and get used to it.

The exercises received during speech therapy will also be adjusted according to the patient's age.

Various things learned by cleft lip patients who take speech therapy, such as:

Develop articulation skills
Learn expressive language skills
Improve the pronunciation of various consonants
Improve vocabulary

Can you prevent cleft lip?

Although cleft lip cannot be prevented, you can consider the following steps to reduce your risk:

1. Consider genetic counseling

If you have a family history of cleft lip, tell your doctor before pregnancy.

Your doctor can refer you to a genetic counselor who can help pinpoint your risk of having a child with this condition.

2. Detecting the fetus

Routine checks can help pregnant women find problems that may befall the baby in the womb, one of which is a cleft lip.

Medical tests that can help detect cleft lips during pregnancy are 3 or 4-dimensional ultrasound (ultrasonography) imaging tests.

This imaging test can be done when the pregnancy is over 6 months of age.

Unfortunately, this test can only identify babies with cleft lip conditions, not with cleft skies.

3. Take prenatal vitamins

Taking a multivitamin before and during pregnancy can help reduce the risk of birth defects, such as cleft lip.

If you are planning to become pregnant in the near future, start taking prenatal vitamins now.

4. Avoid alcohol and cigarettes

Drinking alcohol while pregnant or smoking is strongly discouraged. The reason is, these two things can increase the risk of a baby with cleft lip.

What to do when a child has cleft lip?

When you find out the condition of a baby with cleft lip, maybe you really can't do much to change the situation.

Parents should also start preparing all the care needed by their little one from infancy.

These are some of the things you need to keep in mind:

Don't beat yourself up. Focus on maintaining the health of children from infancy.
Get to know your emotions. It's natural to feel sad and disappointed but try to control your emotions.
Seek support from family, friends, and a special community.

You can support your little one with cleft lip in a number of ways: