Is a cleft palate Genetic?

Question

I was born with a cleft palate because I was premature at birth, and my mother was diabetic. She did not take car of herself at all her sugars were unstable all the time, so they had to take me at 27 weeks. I was 2 pounds and 9 ounces, and I had a cleft palate, club foot, one leg was 1 1/2 inches shorter than the other, an open valve in my heart, and had to have surgery on some other things, the docs were not sure if I would make it, and said if I did I might be mentally retarded, or something similar, and that I might not be able to have kids.

I'm 18 now, and pregnant. I had tons of surgeries over the years, but I no longer have a short leg, club foot, open valve in my heart, I have a bridge so that I have front teeth, and I'm not mentally retarted.

I have turned out just as the doctors thought I wouldn't....normal.

But here is my question. Could my baby have any of these things?
My Doc wants to do a scan to make sure the baby doesn't have a cleft palate. should I be worried?

Answer 1

Here is your "Best Answer"

It is possible that your pattern of malformations are due to a single environmental or teratogenic cause (such as maternal uncontrolled diabetes), a genetic cause (some unknown condition), or combination of both.

You NEED to meet with a genetic counselor and have a good level 2 ultrasound at 20 weeks to evaluate the nose, lips and palate. In addition, due to the cardiac defect, you may need a fetal echocardiogram - ask the genetic counselor who takes a full and complete family history. You may also need a physical exam of yourself by a medical geneticist to determine if there is a single underlying genetic cause to your multiple issues. Based on the findings of the genetic counselor and medical geneticist, you will likely be given a likelihood for recurrence (eg. 3% or 50%, etc.).

Answer 2

Yes. I grew up with a guy that had the cleft, the club foot and the short leg. His sister had the cleft. The doctors told them both that if they had children, they will more than likely have some combination of those birth defects.
The girl didn't listen, she had a baby and it was born with a cleft. She hasn't had it repaired. She says God will fix it. (But that's another show)
The guy, seeing what happened to his sister's kid, had a vasectomy before he could get someone pregnant.

On the other hand, I have a friend whose child was born with a cleft. No one else in her family has that, that she knows of.

My heart goes out to you, you've had to overcome a lot!

Answer 3

Yes you baby should be born with cleft if is was because of genetics. But if it was cause by something happening to you inside the womb then no, you were only born this way because of a birth defect not a bad gene in your blood. My brother was born with cleft palate and all three of his children are normal. But good luck and god bless you, i hope you find the answers you are looking for.

Answer 4

Cleft Palate is a deformity of the development of the cleft (or upper lip and roof of your mouth). I believe it is from the bones not aligning in the womb. It is not genetic, just a formation problem.

Just take care of your body, eat the right foods, and you and your baby should be fine.

Answer 5

As you have shown, medicine can correct many congenital problems. Having a cleft palate is minor compared to other health issues.
This website might help.

Answer 6

cleft palate is not genetic. It is a malformation due to incomplete fusion of the parts that made up the face. You should not worry, as long as you stay healthy during your pregnancy.

Answer 7

1) If you look that one up in "Taber's Medical Cyclopedia" you will find that a major cause is that the mother was a "smoker or tobacco user" and or "Drink" before or during pregnancy.

2) ALSO: Pierre Robin Syndrome is a birth defect in which a child has a much smaller lower jaw (micrognathia). Additionally, their tongues tend to fall further back and downward (glossoptosis) and there palates are cleft and soft. To date the exact cause of Pierre Robin Syndrome has not been found.

Pierre Robin Syndrome causes the lower jaw to slowly grow over the first few months of life prior to birth. Development of the jaw eventually speeds up throughout the first year after birth. The falling back of the tongue can trigger choking episodes and breathing and feeding problems, particularly when a child is asleep. The degree of severity in Pierre Robin Syndrome differs from child to child. Pierre Robin Syndrome is also known as Pierre Robin Sequence and Pierre Robin Complex.

Recent studies have discovered that mothers, who were pregnant and worked on farms where pesticides were often sprayed, frequently gave birth to children who were diagnosed with Pierre Robin Syndrome.

3) MARCHof DIMES SAYS: A cleft is a separation in a body structure. Clefts that occur in the oral-facial region often involve the lip, the roof of the mouth (hard palate) or the soft tissue in the back of the mouth (soft palate). Two major types of oral-facial clefts are cleft lip/palate and isolated cleft palate. Babies with cleft lip/palate have a cleft lip which usually is accompanied by cleft palate. In isolated cleft palate, the cleft palate occurs by itself, without cleft lip or other malformations. These two forms of oral-facial clefts are considered separate birth defects. Here we refer to each specific type of cleft by name, and use the term oral-facial cleft when the information applies to both.

There also are about 400 syndromes in which babies have some form of oral-facial cleft along with a wide variety of other birth defects. The diverse problems of these babies are not described here.

When do oral-facial clefts develop, and how common are they?
These separations normally are present in early fetal development. The lip usually closes by 5 to 6 weeks after conception, and the palate by 10 weeks. The lip or the lip and palate together fail to close in approximately 1 in every 1,000 babies born. Cleft lip/palate occurs more often among Asians (about 1.7 per 1,000 births) and among certain groups of American Indians (more than 3.6 per 1,000 births). It occurs less frequently among African-Americans (approximately 1 per 2,500 births). Males are affected more frequently than females.

Cleft palate occurs alone less often, appearing in approximately 1 in 2,000 babies. Unlike the risk for cleft lip/palate, the risk for isolated cleft palate appears to be similar across all racial groups. Another difference from cleft lip/palate is that females are affected more often than males.

What causes cleft lip/palate?
The causes of cleft lip/palate are not well understood. Studies suggest that a number of genes, as well as environmental factors, such as drugs (including several different antiseizure drugs), infections, maternal illnesses, maternal smoking and alcohol use and, possibly, deficiency of the B vitamin folic acid may be involved.

Cleft lip/palate may occur alone or with other abnormalities that may be hidden or obvious. Up to 13 percent of babies with cleft lip/palate have other birth defects. Some cases involve genetic syndromes which may pose specific problems for the baby, and may have a high risk of affecting others in the family. For this reason, babies with cleft lip/palate should be thoroughly examined by a doctor soon after birth.

Are the causes of isolated cleft palate different?
As with cleft lip/palate, the causes of isolated cleft palate are not well understood. A number of genes as well as environmental factors also may play a role. Antiseizure drugs do not appear to contribute to cleft palate, although maternal smoking and alcohol use and deficiency of folic acid may do so.

Cleft palate appears to be associated with genetic syndromes more frequently than with cleft lip/palate. Babies with what appears to be isolated cleft palate are more likely than babies with cleft lip/palate to have other birth defects, which shows the importance of a thorough examination soon after birth. Studies suggest that up to 50 percent of babies with isolated cleft palate may have other birth defects.

Are oral-facial clefts more common in some families?
If parents without either form of oral-facial clefts have a child with a cleft (and known causes, like syndromes, have been ruled out), the chance that a subsequent baby will have a cleft is 2 to 8 percent. These risk figures are the same for cleft lip/palate and isolated cleft palate. However, a second baby is at risk for only the same type of cleft that affected his or her sibling. If either parent has an oral-facial cleft, but no affected children, the risk of the same type of cleft in any pregnancy is about 4 to 6 percent. If more than one of the parents and/or children are affected, the risk for future offspring is greater.

How do oral-facial clefts affect a baby’s face?
A cleft lip can range in severity from a simple notch in the upper lip to a complete opening in the lip extending into the floor of the nostril. The upper gum may be involved. Clefts can occur on one or both sides, and with or without involvement of the palate. More than 70 percent of babies with cleft lip also have cleft palate.

Cleft palate (whether alone or part of cleft lip/palate) can involve the soft palate only or extend forward through the hard palate. One or both sides of the palate can be affected.

Can oral-facial clefts be repaired?
Surgery often is used to correct cleft lip/palate and isolated cleft palate. The timing and type of surgery depend upon a number of factors, including the preference of the surgeon, the health of the baby and the nature of the cleft. Most surgeons agree that cleft lip should, in most cases, be repaired by about three months of age. Cleft palate repair generally is timed to restore the partition between the nose and mouth as early as possible (often between 9 and 18 months). Additional surgical procedures often are needed as the child grows.

What special problems are associated with oral-facial clefts?
There may be problems with feeding, ear disease and speech development, as well as dental problems. They may differ between children with cleft lip/palate versus those with isolated cleft palate; the problems also will differ depending upon the specific cleft and its severity. Each child with cleft lip/palate or isolated cleft palate requires an individualized treatment plan.

Children with oral-facial clefts usually are treated by a team of specialists so that all aspects of treatment can be coordinated. Most teams include a pediatrician, a plastic surgeon, dental specialists, an otolaryngologist (ear, nose and throat specialist), a speech-language pathologist, an audiologist (hearing specialist), a geneticist, a psychologist and social worker.

What about feeding?
Babies with cleft lip usually do not have much trouble feeding, although those with cleft lip accompanied by cleft palate as well as those with isolated cleft palate sometimes do. A cleft in the roof of the mouth makes it difficult for the baby to suck forcefully enough to draw milk through a nipple. Some babies also have problems with gagging, choking, or milk coming out through the nose while feeding. To make feeding easier, some doctors recommend using a small plastic plate called an obturator that fits into the roof of the mouth and blocks the opening while feeding.

It is possible to breastfeed some infants with cleft palate, although this requires extra patience and modification of techniques. Breastfeeding is more likely to be successful in babies with less severe clefts.

Most cleft palate teams pay close attention to feeding and help parents establish good feeding practices right after the child is born in order to keep problems to a minimum.

What about ear problems?
Babies with cleft palate are especially susceptible to middle ear disease. The cleft can contribute to a buildup of fluid in the middle ear which can cause mild to moderate hearing loss. If the fluid becomes infected, the baby can develop fever and an earache.

If treated properly in infancy and childhood, the hearing loss need not be permanent. If not properly managed, speech development may be affected and hearing loss may become permanent.

All babies with cleft palate should be examined by an ear, nose and throat specialist within the first 3 to 6 months of life. If fluid in the ear is detected, it often can be treated with medications or, in some cases, with a minor surgical procedure to drain the fluid. In persistent cases, the doctor may insert a tiny tube into the eardrum to drain fluids and help prevent infections.

How is speech affected by clefts?
Children with cleft lip generally have normal or near-normal speech. Some children with cleft palate (isolated or as part of cleft lip/palate) may develop speech a little more slowly than other children. Their words may sound nasal and they may have difficulty producing some consonant sounds. However, after cleft palate repair, most children eventually catch up and develop normal speech, although some will require speech therapy or additional surgery.

What about dental problems?
Children whose cleft lip/palate extends into the upper gums (which contain the teeth) have special dental problems. Some primary and permanent teeth may be missing, abnormally shaped, or out of position. Some children with isolated cleft palate also are missing teeth.

Fortunately, these problems generally can be satisfactorily treated with ongoing care by a team of experts, including a pediatric dentist (for routine care), an orthodontist (to reposition teeth using braces), and an oral surgeon (to reposition segments of the upper jaw, when needed, to improve function and appearance and to repair the cleft of the gum).

Can oral-facial clefts be prevented?
While little is known about how to prevent oral-facial clefts, studies suggest that taking multivitamins containing folic acid before conception and during the first two months of pregnancy may help prevent cleft lip/palate and isolated cleft palate.

Other studies have shown that fetuses with certain predisposing genes may be at increased risk for isolated cleft palate if their mothers smoke.

Similarly, one study found that fetuses with a predisposing gene may be at increased risk of cleft lip/palate if their mothers drink during pregnancy. Women who are planning pregnancy or who are pregnant should avoid alcohol, which also can cause a number of mental and physical birth defects. Because some types of medications (such as some drugs used to treat epilepsy) have been linked to increased risk of cleft lip/palate, women who take medications for chronic illnesses should check with their doctors before they become pregnant. (They should not, however, discontinue their medication without discussion with their physician.) In some cases, the doctor may recommend stopping the medication or switching to a medication that is safer during pregnancy. All pregnant women should use only medications prescribed by a physician who knows of the pregnancy, and get early and regular prenatal care, beginning with a pre-pregnancy visit. Families with a history of cleft lip/palate, isolated cleft palate, or any other condition of which clefting is a part, may wish to discuss the chances of recurrence with a genetic counselor.

What research is being done?
March of Dimes grantees and other researchers are investigating many different aspects of oral-facial clefts. A March of Dimes grantee recently identified a gene that causes a rare cleft lip/palate syndrome, and which may contribute to some cases of cleft lip/palate that are not part of a syndrome. Several other genes that may increase susceptibility to oral-facial clefts also have been identified. March of Dimes grantees and other researchers continue to investigate genes that may play a role in causing oral-facial clefts, in order to eventually develop ways to prevent them. Others are studying how excess retinoids (vitamin A derivatives) may contribute to oral-facial clefts; while another is seeking better ways to diagnose and treat speech problems associated with oral-facial clefts.

For more information
Cleft Palate Foundation
104 South Estes Drive, Suite 204
Chapel Hill NC 27514

Velocardiofacial Syndrome, U.S. National Institute on Deafness and Other Communication Disorders


References
American Society of Plastic Surgeons. Cleft lip and palate surgery. Arlington Heights, IL, March 2001.

Children’s Hospital of Philadelphia. Your child’s health: cleft lip-cleft palate. Philadelphia, March 2001.

Cleft Plate Foundation. Cleft Palate Foundation publications. Chapel Hill, NC, March 2001.

Also, checki with "Medline", "Web MD" and a couple dozen more! You have asked a very COMPLOCATED and Big question.