Causes of cleft

After a diagnosis of cleft lip and/or palate it is both common and normal for parents to ask themselves ‘Why did it happen to us?’ Only a few of the families we spoke to had other family members who were born with cleft lip and/or palate. However, most knew other families where someone had been born with a cleft before they received their own diagnosis. With time, most families were able to come to terms with the fact that their baby would have a cleft and that it was not due to any fault of their own or their lifestyle, but due to natural circumstances that were beyond their control.

Becky and Mark did not blame themselves when they found out about their son’s cleft and were realistic about the risks associated with pregnancy.

Andy and Diane found themselves questioning their behaviour when they found out about their son’s cleft. The health professionals reassured them that it was not their fault.

Age at interview 36

Gender Male

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Healthcare professionals do not know exactly why some people are born with a cleft lip and/or palate. However, there is some evidence of a genetic link where cleft lip and/or palate occurs several times in one family. There is also evidence that cleft occurs more frequently in some racial groups than others. At present, it is not known whether tobacco, alcohol and illicit drug use increase the risk of having a baby born with a cleft lip and/or palate.

In the families we spoke to many mothers questioned their own behaviour even if they didn’t drink or smoke during their pregnancy. Some families experienced distress despite the fact that the cleft was probably not caused by anything under their control. On a positive note, most families took reassurance from the health professionals looking after them that the cause of their child’s cleft was not due to any fault of their own.

Safiya’s son is of mixed race and she was told that cleft is more common in babies with her son’s ethnic mix. However, she was also concerned that her own behaviour may have caused the cleft.

Age at interview 21

Gender Female

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Millie and Michael understood the hereditary nature of cleft as both Michael and his father were born with a cleft lip and palate. The couple also had genetic counselling to consider the risk of a further child being born with a cleft.

Age at interview 20

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A few parents had negative reactions from people they knew who suggested that they must have used illicit drugs or drank excessively during pregnancy. Understandably, this caused them lots of unnecessary distress as these beliefs have no basis.

Rebecca and Russell discovered that a local pharmacist believed that their daughter’s cleft was caused by Rebecca using drink and drugs during pregnancy.

Age at interview 23

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Sometimes parents are offered genetic testing after a child is born with cleft lip and/or palate to see whether the family is at risk of other related conditions. Families may also be offered genetic counselling if they are considering whether or not to terminate the pregnancy. Some families felt they would have liked to have had genetic counselling but it was not offered.

Rhiannon had genetic tests but these did not help to identify the cause of her daughter’s cleft palate.

Age at interview 27

Gender Female

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Kendal’s mother Suzi wanted to know the cause of her daughter’s cleft but was too busy looking after Kendal to worry about the cause.

Age at interview 24

Gender Female

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Jenny and her husband had blood samples taken to find out if their baby daughter had any other genetic conditions associated with having a cleft. The tests were negative.

Age at interview 36

Gender Female

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Late diagnosis of cleft

When a baby is born with a cleft palate, healthcare professionals such as midwives, medical consultants, or other specialists hope to be able to diagnose...