Cleft Lip/Cleft Palate

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A cleft lip may be unilateral (affecting only one side, top) or bilateral (bottom). It can range from a small notch to a larger split extending up into the nose.

Cleft lip and cleft palate are birth defects that result in improperly formed lips and/or mouth. Babies born with this birth defect have either an upper lip, palate, or both, that are “cleft,” or split. Cleft lip is an opening in the lip, and cleft palate is an opening in the roof of the mouth. Together, these birth defects are often referred to as orofacial clefts and are among the most common birth defects, occurring in one of every 600 births.  

Cleft lip and cleft palate can range from very mild to more severe and the two conditions can occur separately or together. A cleft lip can range from a small single notch at the top of the upper lip to a double split extending all the way up to the nose and involving the teeth and gums. A cleft palate may be as mild as a small opening in the roof at the back of the mouth, near the uvula, or it may extend all the way to the front of the mouth. Orofacial clefts can either be unilateral, meaning only one side is affected, or bilateral, affecting both sides of the mouth.

Cleft lip and cleft palate are not life-threatening, but they can affect speech, feeding, and hearing, and they need to be repaired. The disfigurement also has an emotional component, especially for parents unprepared for the birth defect. Genetic counseling before and after a child is born with cleft lip/cleft palate, can help parents understand the condition and better participate in a treatment plan. (Find out more about the Craniofacial Program.)

What Causes Cleft Lip/Cleft Palate?
A cleft lip or cleft palate results from improper fusion during early fetal development. Normally, the area between the nose and lip, and the roof of the mouth, fuse together as a fetus grows. When that process goes wrong, a baby will be born with a cleft lip or cleft palate.

What makes that process go wrong is a bit of mystery, but there are several things known to increase the risk of cleft lip/cleft palate. One is genetic — a family history of cleft lip/cleft palate increases the risk that a child will be born with the birth defect.  Another risk factor is heritage — Asian and Native American babies are more likely to be born with cleft lip/cleft palate. Sex also plays a role — boys are more likely to be born with cleft lip with or without cleft palate; however, cleft palate alone is more commonly found in girls. Finally, the health and lifestyle of the mother during pregnancy plays a role — a woman who is obese, or who smokes or consumes alcohol during pregnancy, is more likely to give birth to a baby with cleft lip/cleft palate.

Babies born with cleft lip/cleft palate will need surgery (sometimes several surgeries) to correct the condition; surgery usually produces excellent results when performed by an experienced surgeon with expertise in treating craniofacial anomalies. Children with cleft lip/cleft palate are best treated at a multidisciplinary Craniofacial Program at a major medical center, where the many health professionals a child will need can participate in a unified treatment plan. (See Diagnosing and Treating Cleft Lip/Cleft Palate.)

To make an appointment for an evaluation, or for more information about the Craniofacial Program at Weill Cornell Medicine and NewYork-Presbyterian, please contact:


Ashley Rowley O'ConnorAshley Rowley O'Connor, CPNP, MSN, RN

Craniofacial Clinical Coordinator
Weill Cornell Medicine
Pediatric Brain and Spine Center
525 E. 68th Street, Box 99, Room 2206
New York, NY 10065
Phone: 212-746-1274 
Email: aer9007@med.cornell.edu

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Reviewed by Vikash Modi, M.D.
Last reviewed/last updated: November 2014
Illustration by Thom Graves, CMI