Cleft Lip And Cleft Palate: 7 Things That Probably Will Surprise You

Scars can be barely noticeable after surgery

When it comes to cleft lip and cleft palate, we’ve made some strides in surgical repair of a baby’s lip or mouth when it doesn’t form properly. Despite this, there remains a lot of confusion about these birth defects.

To help clear up misconceptions, plastic and reconstructive surgery specialist Bahar Bassiri Gharb, MD, highlights seven things you may not know about cleft lip and cleft palate:

1. Doctors often identify clefts before the baby is born

“What is not commonly known is that if a baby has a cleft lip and palate, it’s very regularly detected in the prenatal ultrasound during pregnancy,” Dr. Bassiri Gharb says. This can help parents prepare and plan accordingly.

However, if the baby has only a cleft palate (not a cleft lip), it is more difficult to diagnose it with the prenatal ultrasound. An isolated cleft palate is diagnosed prenatally only in 7 percent of the babies.

Preoperative and postoperative photos of two infants with cleft lip and palate who underwent repair surgeries at Cleveland Clinic Children’s. The top patient (left complete cleft) was photographed at 2 weeks of age and then at eight months after surgery. The bottom patient (left incomplete cleft) was photographed at 3 weeks of age and then at four months after repair.

Before and after photos of two infants with cleft lip and palate who underwent repair surgeries at Cleveland Clinic Children’s. The first child (at left) was photographed at 2 weeks of age and then at eight months after surgery. The second child (at right) was photographed at 3 weeks of age and then at four months after surgery.

2. Scars often are hardly noticeable for children born today with cleft palate

Babies with just cleft lip may only require one or two surgeries to repair the lip, which usually begin around three months of age. Doctors repair cleft palate when babies are about 1 year old. According to Dr. Bassiri Gharb, all treatments have improved over time.

“We’ve changed the way we perform repairs and the techniques have been refined, so the scars are hardly noticeable for children who are born with a cleft these days,” she says. “Things have changed over time and I think it’s something most families don’t know but need to understand.”

3. Cleft lip and/or palate is not an uncommon problem

About one out of every 1,000 babies born in the U.S. has cleft lip and/or palate. It is the most common birth deformity of the head and facial bones, and the second-most common birth defect overall behind Down syndrome.

4. African-American babies are less at risk than other ethnic groups

Ethnicity plays a role in terms of risk for cleft lip and cleft palate. For Asian Americans, the likelihood of a baby having cleft lip and/or palate is 1 in 500, and for Caucasians it’s 1 in 750. African American babies have a lower chance, at 1 in 2,000.

5. Boys are twice as likely as girls to be born with it

Gender affects a baby’s odds of having cleft lip and/or palate. Boys are about twice as likely as girls to have it.

6. In half of all cases, cleft lip and cleft palate occur together

In cleft lip, there is a separation between two sides of the upper lip that creates a narrow opening or gap. In cleft palate, a similar type of gap occurs in the roof of the mouth (the palate).

Babies are sometimes born with cleft lip or cleft palate only, or both — and it sometimes develops on one or both sides of the mouth.

The combination of cleft lip-cleft palate occurs twice as often as a cleft lip alone.  

7. Most children grow up to lead perfectly normal lives

According to Dr. Bassiri Gharb, “Parents need to know that in most cases the babies are perfectly fine. They grow normally and do all the things that other children do, and they can go on to achieve great things.”

She continues, “Parents shouldn’t be scared when they hear the diagnosis.” After diagnosis, most parents consult with a team of doctors that will work together to treat all the issues the baby may deal with over the years. “And the results are usually great,” she says. 

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