Causes of Cleft Lip & Palate

Some families have a history of clefting. There may be a grandparent, parent, cousin, brother or sister, or another relative who has had a cleft palate. This may be passed on from generation to generation. However, only 1 out of every 5 clefts are inherited. There are many children born with cleft palates who have no family history of clefting.

Most cleft palates seem to be caused by environmental factors that increase a mother’s risk of giving birth to a child with a cleft palate.

These factors include:

• exposure to German measles (Rubella) or other infections
• certain medications
• alcohol and drug usage
• cigarette smoking
• certain vitamin deficiencies, especially during early pregnancy

Since the baby’s face develops so early in the pregnancy, even when these factors are minimized through proper prenatal care, the damage may have already occurred to the child before the mother was even aware that she was pregnant.

The number of children born each year with cleft palates is growing. Some doctors and scientists believe this rise is caused by the recent increase in teenage pregnancies and the unavailability of proper prenatal care to many pregnant women.

Good prenatal care is one of the best ways to increase the chances of giving birth to a healthy baby.

The chances of having a baby with a cleft palate (without a cleft lip) is thought to be 1 in every 3000 live births. It is more common in Asian and Asian-American populations and less common in Africans and African-Americans. Out of one hundred children born with a cleft palate, sixty of them will be girls and forty of them will be boys.

An important fact to remember is that a baby born with a cleft palate is more likely to have other associated birth defects than babies not born with a cleft palate. Also, infants with a cleft palate only are twice as likely to have associated birth defects than infants born with a cleft palate and a cleft lip.

In general, the risks of giving birth to a child with a cleft palate are highest when both parents have clefts themselves. If only one parent has a cleft palate, the risk of having a baby with a cleft palate is 1 in 20 (5%). If a set of parents, neither of whom have a cleft, gives birth to a child with a cleft, the chances of them giving birth to a second child with a cleft palate is between 2 to 4 percent.

Major issues in prevention of cleft palates are:

• public education about possible environmental and genetic dangers to children
• increased access to prenatal care for mothers
• efforts to decrease teen pregnancies

Women older than 35 must be counseled regarding the maternal age risk factors because older women are more likely to give birth to a child with a birth defect. Also, families with a history of cleft palates should seek genetic counseling to determine their relative risks for giving birth to a child with a cleft palate.