Cleft Lip & Palate

As many of you are already aware, Paul and I are adopting from the Waiting Children's Program, China. This means that our child will have an identifiable special need. In our homestudy, we had to outline exactly what special needs we were comfortable with - and we chose cleft lip and/or palate.

Cleft lips and cleft palates are caused by by abnormal facial development during gestation. A cleft is a fissure or opening - a gap.

Cleft lip is formed in the top of the lip as either a small gap or an indentation in the lip (partial or incomplete cleft) or it continues into the nose (complete cleft). Lip cleft can occur as a one sided (unilateral) or two sided (bilateral).

unilateral incomplete

unilateral complete

bilateral complete

Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. The soft palate is in these cases cleft as well. In most cases, cleft lip is also present.

Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate). It occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes. The hole in the roof of the mouth caused by a cleft ends up connecting the mouth directly to the nasal cavity.

Note: the next images show the roof of the mouth. The top shows the nose, the lips are colored pink. For clarity, the images depict a toothless infant.

Note: the next images show the roof of the mouth. The top shows the nose, the lips are colored pink. For clarity the images depict a toothless infant.

incomplete cleft palate

unilateral complete cleft lip and palate

bilateral complete cleft lip and palate

As a result of the open cavities in the child's mouth and nasal areas, our child may have difficulty eating or drinking. It is possible that the noises he or she makes will sound very nasal, due to the air escaping through the open palate and lip. Our child will require surgery - and most likely more than one. Surgery will take place at Sick Kids Hospital in Toronto, as they have a wonderful cleft lip/palate team at that hospital. Our child may also require extensive dental surgery and most likely many hours of speech therapy.

The good news is that most children with clefts do amazingly well and are quite resilient.

Paul and I are gathering as much material as possible on the condition and even a few reading materials that we can share with our child.

We know that there will be some difficulties that lie ahead for our child, both medically and socially, but we are going to be there with our little one every step of the way....