What is a cleft?
A cleft of the lip and/or palate occurs very early in pregnancy, between 7 and 11 weeks after conception. The face and head form from back to front, normally meeting in the middle and forming the two lines under the nose and the raised ridge running down the center of the palate as they fuse. If the timing is off for some reason, the lip and/or the palate fail to fuse completely, and the resulting gap is the cleft.Paige was born with an (A) incomplete unilateral cleft lip on the right side, meaning the gap does not extend into her nostril, and she does have a complete unilateral cleft palate, meaning the gap in the palate runs all the way from behind her gum line, through her hard and her soft palate, to her uvula in the back. It is not as wide as the palate in picture (D). Her gum line is affected but not complete, meaning it too does not extend to her nose but has a notch that will require a bone graft about age 9.
What causes a cleft? Is it genetic or environmental, or just random?
The causes of clefting are only partially understood. In some cases it runs in families, and some ethnic groups have a higher incidence of clefting, but most of the time there is no family history and no connection to any other health problems. There are also some environmental factors which can increase the risk, such as maternal smoking, certain medications and high exposure to pesticides, but again most of the time it is just a random thing. We were completely surprised by the diagnosis, since we have no family history on either side, and I was extremely careful during the whole pregnancy, doing everything "right."
Clefts are one of the most common birth defect, affecting one in every 700 births in the U.S. We all know people affected by clefts, but most of the time don't realize it because of the wonderful success of repairs, which are performed so early most of us have never seen an unrepaired cleft lip.
View a video that shows one baby's story at a Detroit Hospital:
Paige's timeline so far:
August 30, 2010:
22 week ultrasound reveals cleft lip
September 27th, 2010:
26 week ultrasound shows probable gumline involvement. We can't tell how extensive the palate is involved until birth.
December 2, 2010:
Interviewed cleft team at Children's Hospital of Orange County and will select surgeon from recommendations.
January 2, 2011:
Paige's estimated due date and Birthday!
March 8, 2011:
Ear Tube surgery to help drain fluid and restore hearing went terrific!
March 9, 2011:
Panel meeting with entire CHOC Cleft Team
March 14, 2011:
Consultation with one of the possible Plastic Surgeons
April 4, 2011
Lip and nose repair surgery by plastic surgeon, Dr. Michael Sundine at CHOC
April 11, 2011
Sutures will be removed under anesthesia
Hard and soft palate repair postponed due to month long ear infections
December 12, 2011
Hard and soft palate rescheduled
January 2, 2012
Paige's First Birthday!
TBD
Possible lip and nose revision (About age 4 years)
TBD
Bone graft to complete gum line (About age 8-9 years)
