Cleft Lip & Cleft Palate

What Is a Cleft Lip?

Cleft lip is formed in the upper lip as either a small gap or dent in the lip and can continue into the nose.

What Is a Cleft Palate?

Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined.

How Often does Cleft Lip & Cleft Palate Occur?

In most cases, when cleft palate is found, cleft lip is present as well. Although cleft abnormalities occur in approximately one in every 700 births, they can be treated with surgery shortly after birth with highly successful results.

The results of treatment for cleft lip and palate are usually excellent both aesthetically and functionally. Children born with these conditions have a good quality of life and a normal life expectancy.

If no other members of the family have had cleft lip or palate, the recurrence rate for parents having a second child with this deformity is quite low — approximately 2% if your child has an isolated cleft palate and 4% if your child has cleft lip with or without a cleft palate.

What Are the Types of Cleft Lip & Cleft Palate?

Since an infant’s lips and the palate develop separately, it is possible for a child to be born with a cleft lip only, cleft palate only or both.

Consequently, the conditions can be categorized into three general categories:

• Cleft lip without a cleft palate (isolated cleft lip)
• Cleft palate without a cleft lip (isolated cleft palate)
• Both cleft lip and cleft palate

The condition can occur on one side of the mouth (known as unilateral clefting) or on both sides (known as bilateral clefting.)

What Causes Cleft Lip & Cleft Palate?

Cleft lip and palate are congenital abnormalities (an abnormality present at birth) caused by a failure in facial development during pregnancy.

Is Cleft Lip & Cleft Palate Genetic?

In many babies, it is impossible to pinpoint a cause of cleft lip and cleft palate. The best available research shows it is likely a result of genetic and environmental factors.

Genes that result in cleft lip and palate can be passed on by themselves or as part of a genetic syndrome. If there is a genetic predisposition to cleft lip and palate, there is usually a history of clefting in the immediate family. Family history of cleft lip and cleft palate, as well as some medications during pregnancy, are among the factors that can increase the risk of the condition.

How Is Cleft Lip & Cleft Palate Diagnosed?

Sometimes cleft lip and/or cleft palate are diagnosed through ultrasound (sonogram) when an asymmetry between the right and left nostril or a gap along the gumline appears. Evaluation of the craniofacial structure is part of the routine ultrasound examination done by many obstetricians as part of their routine prenatal care around the 20th week of pregnancy.

Sometimes the condition is not detected before a baby is born. The condition is not always detected in sonograms. When this happens, families usually begin a treatment plan as soon as possible after birth.

Preparation for the Child's Birth

When a fetus is diagnosed with cleft lip and/or palate, the hospital's surgeons and nurses counsel parents about what to expect when their baby is born and reassure them that it is correctable after birth. One of the major obstacles parents find is that their baby is not able to nurse at the breast or use regular bottles, so the staff members focus on educating parents about the differences that they need to be aware of to breastfeed or bottle feed their baby.

Parents are given special bottles designed to easily feed their baby and instructed on how to use them, so they are prepared when the baby is born. If a mother wishes to breastfeed her baby, the baby may need supplemental bottles of pumped breast milk after some feedings until the infant is bigger and stronger. Sometimes the baby will not nurse long enough to reach the milk at the end of the feeding, which is the milk that has the highest concentration of fat and is needed for the baby to gain weight. For this reason, the mother may need to pump her milk after each nursing and supplement the other feedings.

The parents return for an appointment as soon as the baby is born for detailed examination and to receive further instruction on how to feed their child, since feeding is easier to teach after the baby is present.

Treatment for Cleft Lip and Palate

Read details about the surgical treatment for these conditions on Lurie Children’s Cleft Lip and Palate Repair Program page.

Long-Term Effects of Cleft Lip

Long-term effects of a cleft lip are often unnoticed until school age, as this is when patients themselves start to notice that their lip and nose may look a little different than their peers. Lurie Children’s cleft lip and palate team includes psychologists and social workers to help with any possible issues related to confidence or socialization.

Lurie Children’s surgeons make every attempt to see that the scars after a cleft repair are minimized by hiding them in the normal contours of the upper lip and nose. Over time, the scars will fade, and your child’s ability to grow and function normally will continue to improve.

Due to a newborn's outstanding healing abilities, the results of the surgery are excellent both aesthetically and functionally. Children born with this condition have an outstanding quality of life and a normal life expectancy.

Long-Term Effects of Cleft Palate

Long term effects of a cleft palate are related to speech and feeding. Lurie Children’s providers work to overcome secondary problems through the collaboration of our cleft and craniofacial team clinic providers.

Due to a newborn's outstanding healing abilities, the results of the surgery are excellent both aesthetically and functionally. Children born with this condition have an outstanding quality of life and a normal life expectancy.

Lurie Children’s Cleft Repair Team

Lurie Children’s offers the services of an entire cleft lip and palate team, which consists of expert physicians and staff in the following specialties: ear, nose and throat; dentistry; orthodontics; plastic surgery; speech therapy; psychology and social work. Learn more about the Cleft Lip & Palate Program. 

Lurie Children’s recommend that all children with cleft lip and/or palate should be followed by a team certified by the American Cleft Palate-Craniofacial Association (ACPA). ACPA has recognized Lurie Children’s Cleft Lip and Palate/Craniofacial Team as an ACPA Approved Team.

Resources

Learn more about the surgical treatment in the Division of Plastic Surgery pages and the Lurie Children’s Cleft Lip and Palate Repair Program Page. The best-edited source of information comes from Cleft Palate Foundation.