Antidepressants and Cleft Lip and Cleft Palate
Cleft lip / cleft palate: a craniofacial birth defect that affects the upper lip and the roof of the mouth.
Cleft lip and cleft palate are congenital (birth) defects that affect the lip and the palate (roof of the mouth) of a newborn. This defect occurs when the tissue that forms the palate and upper lip fail to join while a fetus is developing. The cleft, or split, can range from a small notch on the upper lip to a large gap that runs through the palate and into the nose. A child may be born with a cleft lip, a cleft palate, or both a cleft lip and a cleft palate.
Cleft lip defined
Isolated cleft lip (cheiloschisis) is a congenital facial deformity that affects the upper lip. This defect can range from a very small indent on the lip (partial cleft) to a large groove that extends to the nose (complete cleft). An isolated cleft lip can be unilateral (only occurring on one side of the lip) or bilateral (occurring on both the left and right side of the lip).
Cleft lip can lead to speech and language delays. The deformity can also lead to complications with psychological and social development.
Cleft palate defined
Isolated cleft palate (palatsochisis) occurs when a child is born with a cleft that only affects the roof of the mouth. Cleft palates account for about 30 percent of all cleft cases. During gestation the two parts of the skull that form the roof of the mouth do not completely join, causing a cleft in the palate. Cleft palate can range from a hole on the roof of the mouth (incomplete) to a complete cleft palate, which includes the soft and hard palate, and can sometimes also include a gap in the jaw.
The cleft connects the mouth to the nasal cavity which can affect feeding, speech and can make breathing difficult for an infant. A cleft palate can also result in ear infections and hearing loss as well as dental development.
Cleft lip / cleft palate defined
A cleft lip/palate birth defect occurs when an infant is born with both a cleft lip and a cleft palate. A cleft palate is normally associated with a cleft lip. About 50 percent of all cleft birth defect cases are diagnosed as cleft lip/palate. Like a cleft lip, a cleft lip/palate can also occur unilaterally or bilaterally.
Treatment for cleft lip and cleft palate
Treatment for cleft lip and cleft palate varies depending on the severity and location of the cleft, but multiple surgeries are often necessary. Surgery is normally recommended at an early age since clefts can interfere with development.
Surgery for cleft lip usually takes place before a child is three months old. Depending on the extent of the cleft, two surgeries may be required.
The procedure to repair a cleft palate is called palatoplasy and is usually performed when the baby is between nine and 18 months old. Multiple surgeries might be necessary if the cleft palate is very severe. Most children with cleft palate will also need orthodontic care, including a bone graft to fill the gap on the gum line.
Follow up care is common after cleft surgeries since a child will likely need guidance on issues of speech, hearing, growth, dental and psychological development.
Causes of cleft lip and cleft palate
Clefts can be caused by genetic or environmental factors. It is unclear what exactly causes the birth defect. Numerous studies have linked the use of antidepressants during pregnancy with a higher risk of certain birth defects. Baum Hedlund is investigating the connection between the use of antidepressants during pregnancy and both cleft lip and cleft palate.
Cleft lip and cleft palate have also been associated with women’s use of the anticonvulsant drug, Topamax (topiramate, during pregnancy. Studies have linked the use of Topamax during pregnancy with a higher risk of cleft lip and cleft palate..