Cleft Lip and Palate
A gap in the baby's upper lip or roof of the mouth
Early in pregnancy, parts of the baby's face grow together. A cleft happens when these parts do not join all the way.
Cleft lip is a gap in the upper lip. It may be on one side or both sides.
Cleft palate is a gap in the roof of the mouth. A baby may have a cleft lip, a cleft palate, or both.
“Isolated” means no other birth difference is found. The lip is usually repaired during the first 6 months of life. The palate is often repaired around 9 to 14 months. The cleft team will choose the safest time for your baby.
Why did this happen?
A cleft forms very early in pregnancy. Most of the time, there is no single known cause.
Genes can play a part. Other health or pregnancy factors may also play a part.
In most cases, there was nothing a parent did to make the cleft happen.
What happens next?
- A detailed ultrasound checks the baby's face and the rest of the body.
- The scan looks for a cleft palate, but the palate can be hard to see before birth.
- You may meet a genetic counselor (a specialist who explains how genes and chromosomes may affect the baby) and a craniofacial team (a team that treats the face and mouth).
- Other scans may be offered if your doctor sees another concern.
What genetic tests are offered?
A cleft can happen by itself. It can also be part of a chromosome (a package of genetic information) or gene (an instruction that helps the body grow and work) condition.
- NIPT / cell-free DNA (a blood screening test that looks at small pieces of pregnancy DNA in the mother’s blood) checks the chance of some common chromosome problems. It does not rule out all genetic causes of a cleft.
- CVS (a test of a small sample from the placenta) or amniocentesis (a test of a small amount of fluid around the baby) can give a more certain answer about the baby’s chromosomes.
- If you choose one of these tests, a chromosome microarray (a detailed test that looks for small missing or extra pieces of chromosomes) is usually offered when a birth difference such as a cleft is seen.
- Sometimes more gene testing (testing that looks for changes in specific genes) is discussed if other problems are seen or the family history suggests one.
What does this mean for my baby?
If the cleft is the only finding and genetic testing is normal, the outlook is usually very good.
A cleft does not usually affect the baby's brain or ability to learn by itself.
A cleft palate can make feeding harder. Some babies need a special bottle. Hearing, speech, and teeth may need extra care as the child grows.
When will my baby's cleft be fixed?
The exact time can be different for each baby. The cleft team (specialists in surgery, feeding, hearing, speech, and teeth) looks at your baby’s health, growth, feeding, and the type of cleft.
The palate should usually be closed by about 18 months. Closing the palate helps with eating and speech as the child grows.
Some children need more surgery later for the lip, nose, palate, teeth, or jaw.
Words you may hear
- Isolated cleft: no other birth difference is found.
- Craniofacial: related to the face and skull.
- Screening test: tells the chance of a condition; it does not give a sure answer.
- Diagnostic test: gives a more certain answer.
- Repair: surgery to close the cleft.
Medical references and guidance
- Society for Maternal-Fetal Medicine. Fetal Anomalies Consult Series #1: Facial Anomalies. 2019; reaffirmed 2025.
- American College of Obstetricians and Gynecologists. Screening for Fetal Chromosomal Abnormalities. Practice Advisory. January 2026.
- ACOG and SMFM. Microarrays and Next-Generation Sequencing Technology: The Use of Advanced Genetic Diagnostic Tools in Obstetrics and Gynecology.
- Centers for Disease Control and Prevention. Cleft Lip/Cleft Palate. Updated January 8, 2026.
- American Cleft Palate Craniofacial Association. Parameters of Care for Evaluation and Treatment of Individuals with Cleft Lip/Palate and/or Other Craniofacial Differences. Revised 2024.