Les fentes labiales et palatines (FLP) sont les malformations faciales humaines les plus fréquentes. Selon l’origine ethnique et/ou géographique des populations étudiées, elles peuvent concerner jusqu’à 1/500 naissances. La venue au monde d’un enfant porteur de FLP est un événement particulièrement stressant et traumatisant pour les parents. Il y a une perte brutale de l’image de l’enfant imaginé qui les bouleverse dans leurs capacités propres de transmission inter-générationnelle. Une écoute attentive des familles dont l’un des enfants est porteur de FLP révèle l’importance du contexte psychologique et les risques d’une structuration dysharmonieuse des relations parents–enfant avec leurs conséquences sur le développement de l’enfant. Lors de l’annonce du diagnostic, et par après, au cours de la prise en charge thérapeutique de cette malformation, l’importance de la qualité toujours renouvelée de l’information par l’équipe de soins est primordiale.

Cleft lips and palates (CLP) are the most common human facial malformations. Depending on the ethnic and/or geographical origin of the studied populations, they can affect up to 1/500 newborns. The treatment of these patients is multidisciplinary because these malformations have not only aesthetic consequences but also functional consequences as the phonation, hearing, deglutition, mastication and ventilation are altered. These consequences can also be psychological since the building of the body image, the way others perceive it, is likely to be seriously altered. Patients presenting with CLP don’t usually seem to present with any serious psychological or psychiatric pathology. Yet a close review of the related literature shows that disorders are actually described: behavioural troubles, anxiety, depression and esthetical dissatisfaction with one’s face in children as well as in adults. The difficulty in interpreting these disorders lies in the various factors that are likely to impact this condition (family setting, importance and type of the cleft, surgery protocol, growth, social environment…). A careful consideration of concerned families show the importance of the psychological context and the risks of a disharmonious structuring of the parents–child relationships on the child’s development. The identification of the difficulties faced by these families, depending on the child’s age, can be easily identified. They can be identified more particularly at birth when the family first sees the child.