Learning that your baby has a cleft lip, cleft palate or both can bring up many questions and emotions. The good news is that they are among the most common birth differences, and treatment has come a long way. Today, most children born with a cleft lip and palate grow up healthy, active and thriving.
According to the American Cleft Palate-Craniofacial Association (ACPA), about 6,000 to 8,000 babies are born in the United States each year with a cleft lip, cleft palate or both. Cleft lip affects about 1 in every 1,050 babies. Cleft palate alone occurs in about 1 in every 1,600 babies.
For many families, care begins before a baby is even born and continues through childhood and adolescence. Understanding what causes a cleft, how it is treated and what to expect along the way can help parents feel more prepared and confident.
This article will answer:
- common questions about cleft lip and cleft palate (including whether they can be prevented)
- the challenges children may face, and
- how treatment helps kids grow, communicate and thrive.
What Is a Cleft?
A cleft lip is a split or gap in the upper lip. A cleft palate is an opening or gap in the roof of the mouth that forms before birth. Both happen early in pregnancy, when the parts of a baby’s face grow and slowly come together. Sometimes those parts do not fully connect, which leaves a gap.
Some babies have only a cleft lip. Others have only a cleft palate. Some babies have both, which doctors call cleft lip and palate. Clefts can be small or large, and they can affect one or both sides of the mouth.
What Causes a Cleft and Can It Be Prevented?
Doctors believe cleft lip and cleft palate develop from a combination of genetic and environmental factors. In many cases, there is no single clear cause.
Some factors may increase the risk, including:
- Genetics: A family history of cleft lip or cleft palate can play a role.
- Environmental factors: Certain exposures during pregnancy may increase risk.
- Smoking during pregnancy: This is linked to a higher chance of clefts.
- Certain medications: Some medicines taken during pregnancy may be associated with clefts.
- Diabetes: Pre-existing diabetes may increase risk.
- Folic acid: Getting enough folic acid supports healthy fetal development, although it does not prevent all cleft lip and palate cases.
Recent research, including studies from institutions such as MIT, is helping scientists better understand how clefts form during early pregnancy. These studies suggest that changes in certain genes may affect how facial tissues grow and connect. If this process is disrupted, the lip or roof of the mouth may not fully join.
This research supports what doctors already know: cleft lip and cleft palate are complex conditions with no single cause in most cases.
Prevention
There is no guaranteed way to prevent a cleft. It develops early in pregnancy, often before a person knows they are pregnant.
How Is a Cleft Diagnosed?
Many clefts are found before birth, while others are not seen until your baby arrives. Doctors often spot a cleft lip during a prenatal ultrasound, usually around the middle of pregnancy. The ultrasound creates a picture of your baby’s face, which can show a gap in the lip.
Can a Cleft Palate Be Detected Before Birth?
Sometimes, but not always. A cleft palate is harder to see on an ultrasound because the roof of the mouth is tucked inside and tricky to view. Because of this, some cleft palates are not found until after delivery.
After birth, a doctor or nurse checks your baby’s mouth during the first exam. They gently look inside to find any opening in the palate. If a cleft is found, your care team can begin planning the next steps right away.
What Happens After a Cleft Is Diagnosed?
After a cleft lip or cleft palate is diagnosed — before birth or shortly after delivery — families are usually referred to a specialized cleft or craniofacial team. This team includes surgeons, speech-language pathologists and feeding or hearing specialists, and work together to plan care for the first months of life.
If a cleft is identified before birth, families have the option to meet the care team during pregnancy. This allows time to prepare, ask questions and understand what to expect after delivery.
From there, care is planned in stages as the child grows. This may include early feeding support, monitoring hearing and speech development and surgical repair at the appropriate time.
What Challenges Can a Baby With a Cleft Expect?
A cleft palate can affect a few different parts of your baby’s daily life. Knowing about these challenges helps you and your care team stay one step ahead.
Feeding
The roof of the mouth helps a baby create suction while drinking. With a cleft palate, suction is harder, which can make feeding more complicated. Special bottles and nipples are designed to help. With the right tools, babies get the nutrition they need and gain weight in a healthy way.
Hearing
Some children, particularly those with a cleft palate, may need small ear tubes placed to help drain fluid and reduce the risk of hearing problems.
Speech
The palate helps shape sounds when we talk. A cleft can make some sounds harder to say as a child learns to speak.
Dental development
A cleft near the gums can affect how teeth grow and how the jaw lines up.
How Is a Cleft Treated?
Treatment for cleft lip and cleft palate varies based on the severity of the cleft, the child’s age and needs and whether there are related medical conditions or syndromes.
The main treatment is surgery to repair the cleft. Cleft lip repair is often performed at about three months of age, while cleft palate surgery is typically performed around nine months of age, before speech development begins. Your surgeon will recommend the best timing based on your child’s needs.
The goals of surgery are to:
- Close the gap in the palate
- Support healthier feeding
- Help speech develop more clearly
It is important to know that treatment often involves more than one procedure. As children grow, some may need additional surgeries, bone grafting, dental care or orthodontic treatment to support healthy speech, tooth development and jaw growth.
Beyond surgery, care is provided by a team with multiple areas of expertise:
- Speech therapy: Speech-language evaluations track your child’s progress and help your child learn to make sounds clearly.
- Orthodontics: Dental specialists keep an eye on tooth and jaw growth as your child gets older.
- Hearing care: Regular hearing checks help catch problems early so they can be treated.
- Follow-up care: Regular check-ins continue through childhood and adolescence to monitor speech, hearing, tooth development and jaw growth.
This team-based approach provides the standard of care and convenience for families of babies with clefts.
Frequently Asked Questions
Is cleft palate genetic?
Sometimes. Genes and family history can play a role, but many clefts happen with no clear cause. Our geneticists are available to answer any questions and provide guidance.
Can a cleft palate heal on its own?
No. A cleft palate does not close by itself. It needs surgery to repair the opening.
How many surgeries will my child need?
It depends on your child. Some need one surgery, while others need several over the years as they grow.
Will my child have speech problems?
Some children do, but speech therapy helps a lot. Many children go on to speak clearly.
Can babies with cleft palate breastfeed?
It can be harder because of the inability to create suction. Often, the baby needs to be bottle fed, but our feeding specialists offer tools and tips to help keep your baby well-nourished.
Can adults receive treatment for cleft palate?
Yes. Adults can still get surgery, speech help and dental care if they need it.
Living Well With a Cleft Lip or Cleft Palate
Most children born with cleft lip and palate grow up to live healthy, active lives. Over time, many children develop clear speech, eat a wide range of foods and build confidence as they grow. A cleft is one part of their health history, but it does not define who they are.
The Stony Brook Cleft Palate-Craniofacial Center provides comprehensive, multidisciplinary care for children with cleft lip, cleft palate and other craniofacial conditions through a coordinated team of specialists including plastic surgery, ENT, oral and maxillofacial surgery, orthodontics, speech pathology, audiology, genetics, dentistry, psychology and social work.
The Center supports patients and families from infancy through adolescence with individualized treatment plans that address feeding, surgical repair, speech and hearing development and long-term follow-up care. Learn more about the Stony Brook Cleft Palate-Craniofacial Center.
