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Cleft Lip and Palate

Download the craniofacial services fact sheet »

What is a cleft lip/cleft palate?

A cleft lip is a separation or opening of the lip. Sometimes this includes the base of the nostril and the upper jaw at the gum line. The palate is the roof of the mouth that extends to the back of the throat. There is a hard and soft portion of the palate. The hard palate separates the mouth from the nasal cavity. The soft palate is the muscular part that helps speech and swallowing.

A cleft of the palate is an opening in the roof of the mouth in which the two sides of the palate did not join together. Clefts can be unilateral (a cleft on one side) or bilateral (a cleft on both sides). It is possible to have a cleft lip only, a cleft palate only, or a cleft lip and cleft palate together.

The lip segments usually join together during the seventh week of pregnancy and the palate usually closes by the eleventh week. When for some reason this process does not occur, the result is a cleft lip and/or cleft palate. There may be genetic or environmental reasons for the clefts. A genetic link is suspected when other family members have clefts. Some clefts can be linked to certain syndromes. However 85% of cases of cleft lip with or without cleft palate are isolated and not related to other medical conditions. When a cleft palate occurs alone without a cleft lip, there is a greater likelihood that it is related to a syndrome. It is a good idea to have a genetic evaluation to identify possible causes, particularly if an additional anomaly is identified.

Clefts are among the most common birth defects and occur in 1 in 600 newborns. There is a 2-5% chance that parents of one child with a cleft will have another child born with a cleft. The risk of having a child with a cleft increases if there are other family members with clefts.

What is the treatment of cleft lip/cleft palate?

There are no fetal treatments for clefts. Surgical repair is done in two stages during the first year of life.  The lip is repaired at 3-6 months of age and the palate is repaired between 10-12 months. The actual timing depends on the type of cleft, the child's growth and on the pre-surgical treatment plan.  The lip repair is generally an outpatient surgery and the baby goes home the same day.  Palate repairs require a 2-3 day hospital stay.

What special considerations should be made for delivery?


Will I be able to breast feed?


What are the long-term outcomes and considerations?

The Cleft Team which includes pediatric plastic surgeons will periodically assess your child's appearance, speech and dental needs until full facial growth is reached.  Speech therapy is usually needed following the palate repair and during primary school years.  Prior to the development of the secondary teeth (age 7-9), the gap in the alveolar ridge (gum) will be surgically closed.  Most children will need orthodontic braces, usually at the same age as many of their classmates. Depending on the severity of the cleft, some children may require secondary surgeries to improve appearance or function as they grow.

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