Cleft Lip and Cleft Palate

What Is a Cleft Lip or Palate?

The word “cleft” means "split."

• A cleft lip is a split in the upper lip. It can be on one or both sides and sometimes extends to the upper gum or jaw.
• A cleft palate is an opening in the roof of the mouth. The front part of the palate is made of bone (called the hard palate), and the back part is muscle (called the soft palate).

Sometimes, a cleft is hard to see. This is called a submucous cleft palate - where the cleft is hidden by tissue inside the mouth. These types of clefts may go unnoticed until a child begins to have problems talking or eating.

A person can have a cleft lip, cleft palate, or both. Clefts can happen anywhere on the palate or upper lip, and can be on one or both sides of the upper lip. The split may also be in the upper jaw and gum.

Cleft lips and palates develop before a baby is born, but they can also affect adults if left untreated.

What Are the Causes of Cleft Lip and Palate?

There’s no single cause for clefts, but they form early in the growth of a fetus. Some risk factors include:

• genetics (family history)
• smoking, drinking alcohol, or using drugs during pregnancy
• having diabetes during pregnancy
• taking certain medicines while pregnant
• limited access to prenatal health care

Some families might also have additional cultural beliefs about the causes for cleft lip or palate.

Who Is on the Cleft Lip and Palate Care Team?

Cleft lip and palate are best treated by a specialized care team, often called a cleft palate or craniofacial team. This team may include these professionals:

• audiologist
• dentist
• dietitian or nutritionist
• ear, nose, and throat doctor (ENT)
• nurse
• orthodontist
• plastic surgeon
• psychologist
• SLP
• social worker

To find a care team near you, visit the American Cleft Palate Craniofacial Association website.

What Does Testing Speech, Hearing, and Feeding Look Like?

Children with a cleft may need testing to check their speech, hearing, and feeding skills. A cleft palate team usually tests these skills in a medical setting when a child is young.

Physicians and other medical professionals work together with the family to find out:

• what kind of cleft it is
• if speech, hearing, and feeding are affected
• what types of services may help

An SLP may check how your child says sounds or words to see if they may have a cleft that is affecting their speech.

An audiologist may check for hearing problems. Children with cleft palate often get more ear infections or have extra fluid in the ears, which can affect hearing. Monitoring hearing - especially from birth to age 6 - is important.

What Is the Treatment for Cleft Lip and Palate?

Cleft lip and cleft palate are usually treated with surgery, along with dental and orthodontic care. But treatment continues after surgery—your child’s care team also supports feeding, speech, and hearing.

Feeding and Swallowing Support

SLPs can help with feeding and swallowing skills.

• Babies with a cleft lip only usually don’t have feeding problems.
• Babies with a cleft palate may have trouble breastfeeding or bottle-feeding because of the opening in the roof of the mouth. They may need special bottles or nipples if they bottle-feed.

SLPs can help you:

• find the right bottle-and-nipple combination
• make feeding easier
• offer support for later feeding concerns as your child grows

Physicians and the rest of the team will also watch your child’s growth and nutrition.

Learn more about feeding and swallowing in children and adults.

Speech Support

Not all children with a cleft will have speech problems, but those with a cleft palate may need help learning to speak more clearly.

SLPs work with children and adults to:

• practice making speech sounds
• help them talk more clearly
• build confidence in communication

Hearing Support

Audiologists help manage hearing and balance issues. Hearing issues can happen with frequent ear infections or extra fluid in the ears, which are common with cleft palates.

An audiologist can:

• identify and address hearing loss, in coordination with your child’s doctor
• check your child’s hearing regularly
• recommend tools like hearing aids or other hearing devices, if needed

Every person with a cleft lip or palate is different—but with the right support and care plan, they can communicate, grow, and thrive.

To find an audiologist or SLP near you, visit ProFind.

Resources

Inclusion on this list does not imply endorsement.

• American Cleft Palate-Craniofacial Association
• Facts About Cleft Lip and Cleft Palate