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Cleft Lip


What Is a Cleft?

A cleft is when a baby is born with an opening in the lip and/or roof of the mouth (palate). These birth defects are treatable. Most kids can have surgery to repair them early in life.

What Is a Cleft Lip?

Babies who are born with cleft lip have a gap or opening in the upper lip. This happens when the baby's lip doesn't form properly early in pregnancy, resulting in a split.

A cleft lip can be:

  • on one side of the lip (a unilateral cleft lip)
  • on both sides of the lip (a bilateral cleft lip)

illustration

Most cleft lips are unilateral. In most cases, the cleft is in the upper lip only and doesn't affect the lower lip.

Clefts can range in size:

  • Some are just a small notch in the lip (an incomplete cleft lip).
  • Others extend from the lip through the upper gum and into the nostril (a complete cleft lip). This can make the baby's nose look wider and shorter than normal, especially when there are clefts on both sides of the lip.

A baby may be born with just a cleft lip or might also have a cleft palate, which is a split in the roof of the mouth.

How Is a Cleft Lip Diagnosed?

Usually, cleft lip is found when a baby is born. Somtimes, the problem is seen on a prenatal ultrasound.

Cleft lip can be associated with problems involving feeding, growth and development, ear infections, hearing, and speech development. So it's important to correct a cleft lip with surgery while a child is young.

How Is a Cleft Lip Treated?

Most babies who have a cleft lip have a surgery called cheiloplasty (KY-lo-tuh-plass-tee) to repair it when they're 2–10 weeks old. This is done in the hospital while the baby is under general anesthesia.

The goals of cheiloplasty are to:

  • Close the cleft.
  • Create a more normal appearance by:
    • forming a cupid's bow (the curves in the center of the upper lip)
    • creating more space between the upper lip and nose

If the cleft lip is wide, special procedures like lip adhesion or a molding plate device might help bring the parts of the lip closer together before the lip is fully repaired. Cleft lip repair usually leaves a small scar on the lip under the nose.

cleft lip repair illustration

If the cleft lip also affects the shape of the nose, a baby might have other surgeries to improve its appearance (for instance, to fix the shape of the nostrils).

What Else Should I Know?

A baby with a cleft lip can sometimes have other health problems, such as:

  • trouble feeding
  • fluid buildup in the middle ear
  • hearing loss
  • dental problems
  • speech difficulties

It's important to work with a care team to help manage any problems. Besides the pediatrician, a child's treatment team might include:

  • plastic surgeon
  • ear, nose, and throat (ENT) physician (otolaryngologist)
  • oral surgeon
  • orthodontist
  • dentist
  • speech-language pathologist

You might also work with a:

  • social worker
  • psychologist or therapist
  • geneticist
  • team coordinator

When Should I Call the Doctor?

Cheiloplasty and the other procedures done to help kids born with a cleft lip have seen major improvements in recent years. Most kids who undergo them have very good results. There are risks with any surgery, though, so call the doctor if your child:

  • has a fever above 101.4˚F
  • has lasting pain or discomfort
  • has heavy bleeding from the mouth
  • can't drink fluids

Looking Ahead

Most kids with cleft lip are treated successfully with no lasting problems.

The psychologists and social workers on the treatment team are there for you and your child. So turn to them to help guide you through any hard times. You also can find more information and support online: