Cleft Lip and Palate

What is cleft lip and a cleft palate?

A cleft lip is an opening or split in the upper lip. It can look like a small notch or can extend up into the nose. It may occur on one side (unilateral) or both sides (bilateral) of the lip.

A cleft palate is a gap in the roof of the mouth. It can affect the back part (soft palate), the front part (hard palate), or both. Sometimes, it also involves the small tissue at the back of the throat (uvula).

It occurs when different parts of a baby’s face don’t join while they are developing in the womb resulting in a gap.

Babies can be born with a cleft lip, a cleft palate, or both. The condition varies, and some clefts require more treatment and care than others.

Most scans only pick up a cleft lip. Scans cannot always find a cleft palate, even if a cleft lip can be seen.

Follow-up tests and appointments

If a scan suggest that your baby may have cleft lip, we will refer you to the specialist fetal medicine team who will offer more scan. These can confirm if you baby has cleft lip, they type of cleft lip and what this might mean. They may also offer extra tests such as amniocentesis (removing amniotic fluid to check for genetic or chromosomal conditions). This condition will should not affect how you deliver your baby.

Causes

We do not know exactly what causes cleft lip. It is the most common facial birth condition in the UK, affecting around 1 in 700 babies. It is unlikely to be due to anything the mother did nor didn’t do during pregnancy. It is sometimes liked with conditions affecting your baby’s chromosomes.

How do we find cleft lip/palate?

At the routine 20-week anomaly scan (between 18+0 and 20+6 weeks of pregnancy), we screen for cleft lip. Most cases are found during this scan but sometimes they may not be identified, especially if they are very subtle or small. It is difficult to find cleft palate on routine scan, even if cleft lip is seen.

How will this affect my baby?

Cleft lip is a wide and varied condition. With proper care, children with cleft lip and palate can grow up healthy and thrive like any other child. Without treatment, a cleft lip or palate can lead to:
o Difficulty with feeding
o Speech problems
o Ear infections or hearing loss
o Dental issues

Can it be treated?

An operation to reconstruct the shape of the lips and nose is usually required and usually takes place when the baby is less than one year. Surgery to repair a cleft lip may leave a scar above the baby’s lip which will fade over time and become less noticeable as they get older.

  • Cleft lip repair is usually done in the first few months of life.
  • Cleft palate repair typically happens between 9 and 18 months of age.

A team of specialists such as cleft surgeons, speech and language therapists, orthodontists and other healthcare professionals will be involved in your baby’s care.

Future pregnancy

In most cases, you will not have another baby that is affected. The risk of having a child with a cleft lip or palate is slightly increased if you've had a child with the condition before, but the chances of this happening are thought to be around 2 to 8% ( 2 to 8 in 100). This is also the case if either you are you partner were born with a cleft lip or palate