• Cleft palate, «PAL iht», is a birth defect marked by a split or cleft in the roof of the mouth, generally accompanied by a cleft in the lip. Cleft palate and lip occur when the tissues that form the palate and lip fail to fuse (unite) during the early weeks of an unborn child’s development. A cleft palate may involve both the hard palate—the bony tissue that makes up the front part of the mouth’s roof—and the soft palate—the tissue that forms the rear part of the roof of the mouth. Alternatively, a cleft may involve the soft palate only. The most common type of cleft involves both the palate and lip. However, some individuals are born with a cleft palate or cleft lip alone. Cleft lip and palate occur in about 1 of every 600 live births.
    A cleft palate usually affects eating, speech, and hearing. The hole in the roof of the mouth may cause an infant to have difficulty sucking milk. Adjustments in feeding are often necessary to ensure that the infant gets proper nutrition. During normal speech, the soft palate moves up and back to contact the back of the throat, separating the mouth from the nose. This separation is necessary to produce most consonant sounds. Such a separation cannot be attained with a cleft palate, and air passes into the nose, creating a nasal quality when the person speaks. Cleft palate can also lead to chronic ear infections. The cleft interferes with the muscle that opens the Eustachian tube, which connects the middle ear with the back of the throat. As a result, fluid from the middle ear does not drain efficiently, frequently resulting in infection.
    Doctors can perform surgery to close clefts of the palate and lip. They usually close a cleft lip during the first three months of life to produce minimal scarring. Surgery on the palate usually occurs at about the age of 1. The primary goal of the surgery is to close the cleft and provide a soft palate that can move normally during speech. Surgery also improves a child’s ability to feed and reduces ear infections.
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