The word cleft means a gap or split between two things. A cleft lip is a split in the upper lip. This can happen on one or two sides of the lip, creating a wider opening into the nose. A cleft palate is a split in the roof of the mouth. This leaves a hole between the nose and the mouth.
Sometimes a cleft lip and cleft palate occur together. Cleft lip and cleft palate are very common and occur in about 1 or 2 of every 1,000 babies born in the United States each year.
Cleft lip and cleft palate are birth defects. This means they happen while a baby is developing. Normally, the mouth and nose of a baby develop between the first 6 and 12 weeks of growth inside the mother. In some babies, parts of the lips and roof of the mouth don't grow together. Because the lips and the palate develop separately, it's possible to have cleft lip alone, cleft palate alone, or both together.

The use of ultrasound before birth of the offspring can detect the presence of cleft in an infant, but a physical examination of the lip, mouth, and nose can only confirm the true presence of the disorder. One good thing about diagnosis testing is that it has been known to rule out any other forms of abnormalities.

What Happens to a Kid With Cleft Lip or Cleft Palate?
A baby with cleft lip and cleft palate may have other difficulties that include feeding problems, middle ear fluid and hearing loss, dental problems, and speech problems.
Several factors may increase the likelihood of a baby developing a cleft lip and cleft palate, including:
Risk factors

* Family history. Parents with a family history of cleft lip or cleft palate face a higher risk of having a baby with a cleft. * Race. Cleft lip and palate are most common in American Indian and Asian children. African American children are least likely to have a cleft. * Sex. Males are twice as likely to have a cleft lip with or without cleft palate. Cleft palate without cleft lip is more common in females. * Exposure to certain substances during pregnancy. Babies born to women who smoked or drank alcohol during pregnancy are more likely to develop cleft lip and cleft palate. * Being obese during pregnancy. There is some evidence that babies born to obese women may have increased risk of cleft lip and palate.

Genes identified
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The total sample identified four genes strongly associated with risk for cleft lip and/orcleft palate. Families of European ancestry, including European Americans, had the strongest statistical support for the region on chromosome 8. Asian families (from China, Korea, Singapore, Taiwan and the Philippines) had strongest support for IRF6, MAFB and ABCA4 genes. In addition to findings in humans, the investigators showed the MAFBgene was active in the developing head and mouth of embryonic mice, which further argues this gene plays some role in normal development. The IRF6 gene provides instructions for making a protein that plays an important role in early development. The ABCA4 gene provides instructions for making a protein that is found in the retina, the specialized light-sensitive tissue that lines the back of the eye. MAFB, plays an important role in the regulation of lineage-specific hematopoiesis.
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Cleft Lip Treatment
Cleft lip surgery is usually performed when the infant is about 10-12 weeks old. The goal of surgery is to close the separation, restore muscle function and provide a normal shape to the mouth. The nostril deformity may be improved as a result of the procedure or may require a subsequent surgery.
For cleft lip, surgery is used to close the different segments in the lip. This surgery will give the child a better appearance of their face. It will provide a better appearance compared to before and improve facial structure. Cleft lip will have minor or major cleft in the lip, with a few times found in the nose as well. A slight cleft defines it as unfinished, in which the cleft or only small portion of cleft is formed. The cleft that occurs to the nose is knows as completer cleft.

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Cleft Palate Treatment
Cleft palate is similar to cleft lip in that cleft palate is when both parts of the skull are not fused together in the hard palate and the small palate might also show some defects. A gap may occur in the jaw and is known as complete cleft. The roof of a child’s mouth might have a hole in it and is known as incomplete cleft palate.
For cleft palate, the surgery will improve the palate in the roof of the child’s mouth. Surgery might be needed on either side or both side, depending on the situation of the child. A cleft palate is initially treated with surgery safely when the child is between 7 to 18 months old. This depends upon the individual child and his/her own situation. For example, if the child has other associated health problems, it is likely that the surgery will be delayed.
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------------------------------------------------- surgery Goals
The major goals of surgery are to:
1. Close the gap or hole between the roof of the mouth and the nose.
2. Reconnect the muscles that make the palate work.
3. Make the repaired palate long enough so that the palate can perform its function properly.
There are many different techniques that surgeons will use to accomplish these goals. The choice of techniques may vary between surgeons and should be discussed between the parents and the surgeon prior to the surgery.
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What can be expected after the surgery?
After the palate has been fixed, children will immediately have an easier time in swallowing food and liquids. However, in about 1 out of every 5 children following cleft palate repair, a portion of the repair will split, causing a new hole to form between the nose and mouth. If small, this hole may result in only an occasional minor leakage of fluids into the nose. If large however, it can cause significant eating problems, and most importantly, can even affect how the child speaks. This hole is referred to as a "fistula," and may need further surgery to correct.

Without health insurance, cleft lip and/or palate surgery typically costs $5,000 to$10,000 or more per surgery; if the child has both a cleft lip and a cleft palate, two surgeries typically are required for a total of $10,000 to $20,000.