Cleft Lip and Palate: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Cleft Lip and Palate?
A plastic surgeon is one type of doctor who treats cleft lip and palate. A child is often referred to a team that may include an otolaryngologist (ear, nose, and throat doctor), an oral surgeon, and a speech pathologist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is cleft lip and palate?
Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during pregnancy. A baby can have a cleft lip, a cleft palate, or both. A cleft lip happens if the tissue that makes up the lip does not join completely before birth. The roof of the mouth is called the palate. With a cleft palate, the tissue that makes up the roof of the mouth does not join correctly. In the United States, about 1 in every 1,050 babies is born with cleft lip with or without cleft palate. About 1 in every 1,600 babies is born with cleft palate alone.
Symptoms
How severe a cleft is can vary a lot. A cleft lip may be just a small notch in the lip, or a complete split that goes all the way to the base of the nose. Other signs and problems can include:
- A change in the shape of the nose.
- Poorly aligned teeth.
- Failure to gain weight and poor growth.
- Feeding problems, including milk flowing through the nose during feeding.
- Repeated ear infections.
- Speech difficulties.
Children with a cleft lip or cleft palate are also more likely to have hearing loss.
Causes and who gets it
There are many causes of cleft lip and palate. Problems with genes passed down from 1 or both parents, drugs, medicines, viruses, or other toxins can all cause these birth defects. Babies are more likely to be born with a cleft lip and palate if they have a family history of these conditions or other birth defects. A mother's poor health in early pregnancy may increase the risk. So may drinking alcohol, smoking cigarettes, or taking certain anti-epileptic medications. Cleft lip or palate are found in more than 400 syndromes. Approximately 30 percent of cleft defects are associated with a genetic syndrome.
How doctors diagnose it
A cleft lip may be diagnosed in pregnancy during a routine ultrasound. It will usually be visible during a baby's first examination. Some types of cleft palate are not easily visible and might not be diagnosed until later in life. A physical exam of the mouth, nose, and palate confirms a cleft lip or cleft palate. Medical tests may be done to rule out other possible health conditions. A thorough medical exam and genetic counseling are recommended for children and their parents to find out whether their future children may be affected.
Treatment
Treatment depends on the size of the cleft, the child's age and needs, and whether there are additional problems related to a genetic syndrome. Surgery is often used to close the lip and palate. Cleft lip surgery is usually done before a baby's first birthday, and cleft palate surgery is done before 18 months. Sometimes a prosthetic device is temporarily used to close the palate so the baby can feed and grow until surgery can be done. If there are other problems as children get older, a child may need additional surgeries, dental and orthodontic care, and speech therapy. Your child may still have problems with speech after the surgery, and speech therapy will help. Hearing problems are common in children with cleft lip or palate. Your child should have a hearing test at an early age, and it should be repeated over time. With treatment, most children with cleft lip or palate do well and lead a healthy life.
When to see a doctor
Cleft lip and palate is most often diagnosed at birth. Follow your health care provider's recommendations for follow-up visits. Contact your provider if problems develop between visits. Ask for advice if your baby has problems nursing or drinking from a bottle. Call 911 or go to the emergency room if a child has trouble or abnormal breathing, bluish or grey skin, a seizure, or unconsciousness.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A child with cleft lip or palate is often referred to a team of experts. Talk to the people who are treating your baby and ask them to explain what you do not understand.
Common questions
When is surgery done for cleft lip and palate?
Cleft lip surgery is usually done before a baby's first birthday, and cleft palate surgery is done before 18 months.
Does cleft lip and palate affect hearing?
Yes, hearing problems are common in children with cleft lip or palate. Your child should have a hearing test at an early age, and it should be repeated over time.
Can cleft lip and palate cause feeding problems?
Yes, children with a cleft lip or a cleft palate often have problems with feeding and talking. There are many ways to overcome feeding challenges.
Do children with cleft lip and palate do well?
Yes, with treatment, most children with cleft lip or palate do well and lead a healthy life.
Sources
- MedlinePlus - Cleft Lip and Palate
- MedlinePlus - Cleft lip and palate (Medical Encyclopedia)
- National Institute of Dental and Craniofacial Research - Cleft Lip and Palate
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
