Posted by Fiona Cole on May 6, 2011
Various studies have found links between the use of antidepressant medication, such as Effexor and Zoloft, by pregnant women and an increased risk of certain birth defects. Among the birth defects being investigated are cleft lip and cleft palate defects. A recent FDA warning has also linked the anticonvulsant drug, Topamax, to an increased risk of oral cleft problems.
Oral cleft birth defects affect the baby’s upper lip and/or the roof of the baby’s mouth, also known as the palate. During the development of the fetus, the upper lip and/or palate fail to join. The “cleft” refers to a split which can vary in size from a minimal notch on the baby’s upper lip to an extensive gap that divides the roof of the baby’s mouth and runs up into the baby’s nose. Oral cleft birth defects can come in the form of just a cleft lip or just a cleft palate, or a combination of the two.
A cleft lip alone can range from a tiny indent on the baby’s upper lip, which is referred to as a partial cleft, to a deep groove that runs all the way from the upper lip to the baby’s nose, which is called a complete cleft. A cleft lip can form only on one side of the baby’s upper lip (unilateral) or on both the right and left side of the baby’s upper lip (bilateral). When a baby is born with an isolated cleft lip, if left untreated, it can lead to language and speech difficulties. A cleft lip, by virtue of its abnormal appearance, can also cause psychological and social challenges.
An isolated cleft palate is when the cleft, or split, affects only the roof of the baby’s mouth. Cleft palates constitute approximately 30 percent of all oral cleft birth defect cases. As the fetus is developing in the womb, the two parts of the baby’s skull that make up the roof of the mouth fail to fuse properly. This is what causes the cleft, or split, in the palate. Like cleft lips, cleft palates can vary greatly in size from an incomplete cleft palate, which is just a hole in the roof of the baby’s mouth, to a complete cleft palate. When the cleft palate is referred to as complete, it means that the split runs across the hard and soft palate of the baby’s mouth and it can also extend to a gap in the baby’s jaw.
Because of the connection of the roof of the mouth to the nasal cavity, cleft palate defects can cause speech, feeding and breathing difficulties. Hearing loss, ear infections and dental issues can also arise.
Around 50 percent of all oral cleft birth defects are a combination of the two. When this is the case, a cleft lip/palate defect, like the cleft lip alone, can occur on one or both sides of the baby’s mouth.
Oral cleft birth defects interfere with the baby’s development. But the good news is that they are treatable with surgery. Doctors usually recommend surgery early on to ensure that the baby develops normally and complications can be avoided. Treatment for any form of an oral cleft birth defect will depend on the location and severity of the split; in some cases, multiple surgeries are required.