Just one year after Love Without Boundaries was organized as a charity in 2003, we organized our very first cleft trip to China. During this first trip, over 50 babies and children born with cleft lip and palate were healed by a team of American medical professionals who generously donated their time and expertise. This LWB model remains in place today, and it is why we continue to provide this critical surgery to impoverished children.

When someone sponsors a cleft surgery through LWB, they are paying only those costs directly related to the surgeries, such as operating room expenses, supplies, and the nutritional support necessary to get waiting babies up to the necessary weight to qualify for surgery.
Plans are now well underway for our first cleft mission to Guatemala later this year. 60 children are waiting and scheduled to receive their life-changing surgery. We can’t wait to meet them and their families!

Before our next trip occurs, we wanted to share some commonly-asked questions about cleft and why it’s so important that cleft-affected children receive surgical care.
What are Cleft Lip and Palate?
Cleft lip and cleft palate are also called orofacial clefts, and they occur when a baby’s lip or mouth does not properly form during pregnancy. A cleft lip is an opening in the lip. A cleft palate is an opening in the roof of the mouth. Both types of cleft occur during the first three months of pregnancy when the tissue of the lip and palate fail to fuse together. They are one of the most common birth defects.

Not all babies born with cleft lip have cleft palate, and vice versa. Some children are born with both conditions.
Types of Cleft Lip
There are three main types of cleft lip:
- Microform cleft lip (or forme fruste)
- Unilateral cleft lip
- Bilateral cleft lip
Microform Cleft Lip
Microform is the mildest form, considered incomplete cleft lip, and may not be very apparent visually. Even so, it can still result in significant functional difficulties.

Unilateral Cleft Lip
Unilateral cleft extends on only one side of the upper lip.

In the case of complete unilateral cleft lip, the cleft extends all the way from the cleft to the nose. Incomplete cleft lip does not extend to the nose completely and the floor of the nostril remains intact. This is the most commonly diagnosed cleft lip, and the left side is more often affected.
Bilateral Cleft Lip
Bilateral cleft affects both the right and left side of the upper lip and, just as with unilateral cleft, it can be described as complete or incomplete.

More Rare Forms of Cleft
More rare forms of cleft can be divided into three categories: clefts through the center of the face, oro-nasal-ocular clefts (involving the mouth, nose and eyes), and lateral clefts associated with Treacher Collins syndrome, hemifacial microsomia, and other syndromes characterized by differences of the lower jaw.
Facts About Cleft Palate
Cleft palate occurs when the roof of the mouth does not close completely during delta development. The result is an opening that can extend into the nasal cavity. It may occur in the front of the mouth (the hard palate) to the throat (soft palate). Often, a cleft palate will also include a cleft lip.
Cleft palate is not as apparent as cleft lip because it is inside the mouth. Some children may have a less noticeable form of cleft palate, called submucous cleft palate, in which the cleft is covered by the mucous membrane that lines the roof of the mouth.
Children may be born with only a cleft lip, only a cleft palate, or a cleft lip and palate. These differences may be isolated or related to a syndrome.
Ideally, infants will have their cleft lip repaired between three and six months of age, and receive their first palate repair surgery between 9 and 18 months. However, sometimes children from impoverished families wait months or even years for the repair they desperately need.
Why Are Some Babies Born With Cleft?
Although the exact cause of a child’s orofacial cleft may be unknown, genetics sometimes play a role. The genes passed down by one or both parents, or the association with a syndrome, may result in a child being born with cleft.
Other potential causes may be environmental in nature, and include things such as exposure to toxins or certain medications, or even malnutrition. A traumatic injury during prenatal development can potentially also result in a cleft. Sometimes no cause can be identified.
Why Is It Important for a Cleft-Affected Child to Receive Surgery?
There are many reasons why it is critical that a child born with cleft has a repair surgery while they are young.

Without treatment, a child born cleft-affected will face many serious challenges. These include difficulty feeding, poor growth and overall development, dental issues, frequent ear infections, hearing loss, and speech development problems. Individual care plans are created for children with cleft lip and/or palate to ensure that the appropriate treatment and intervention occur at just the right time so that the best outcomes can be achieved.

Difficulties Associated with Cleft Lip and Palate
Feeding Difficulties
It can be challenging for babies born with either cleft lip or palate to suck and take in adequate nutrition. Cleft bottles can help cleft-affected babies gain the weight they need to prepare for cleft repair surgeries.

Speech Challenges
Children with unrepaired cleft lip and palate often experience delayed speech development. Their speech can have a nasal quality.

Dental Problems
Tooth development can be a problem if a cleft extends through the upper gum.

Ear Infections
Ear infections and middle ear fluid can develop in babies born with cleft palate; this can lead to hearing loss if left untreated.
Social Issues
Children with unrepaired cleft lip and palate can suffer isolation as their condition may be stigmatized in some cultures around the world.

How Can I Help a Child Born with Cleft Lip or Palate?
You can help by sponsoring all or part of a cleft surgery for a waiting child. Most of these children are from families who are unable to afford the cost of cleft repair surgery on their own.

Thanks to an agreement reached with the hospital and the generous donation of our cleft team’s time, each cleft surgery done during our cleft missions typically cost just $600. We would also be grateful to receive your one-time donation in any amount to support a child’s cleft surgery.

Thank you in advance for considering a cleft surgery sponsorship. Your gift today will make a lasting difference in the life of a child in need.
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