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. These orofacial clefts are some of the most common birth defects. Most kids can have surgery to repair them early in life. A baby with a cleft might have: only a cleft lip only a cleft palate both a cleft lip and a cleft palate A cleft lip can be: on one side of the lip (a unilateral cleft lip). This type is more common. on both sides of the lip (a bilateral cleft 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. What Causes Cleft Lip? During the first 6 to 10 weeks of pregnancy, the bones and skin of a baby's upper jaw, nose, and mouth normally come together (fuse) to form the roof of the mouth and the upper lip. A cleft lip happens when parts of the upper lip and/or gum do not fuse together completely. Doctors don't always know why a baby develops a cleft lip, though some clefts may be related to genetic (inherited) factors. Also, some environmental factors can increase the risk of a birth defect, such as: taking certain medicines (such as some anti-seizure medicines) during pregnancy not getting the right amount of prenatal nutrients exposure to some chemicals during pregnancy smoking cigarettes, using drugs, and/or drinking alcohol during pregnancy How Is a Cleft Lip Diagnosed? Usually, cleft lip is found when a baby is born. Sometimes, it's seen on a prenatal ultrasound. Cleft lip can be associated with feeding problems. Later in life, it may lead to dental problems, speech problems, and even issues with self-esteem and social interactions. 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-plass-tee) to repair it when they're about 3 months old. This is done in the hospital while the baby is under general anesthesia. The goals of cleft lip repair are to: Close the cleft. Create a more normal shape and contour of the upper lip and nose. If the cleft lip is wide, special procedures like lip adhesion or nasal alveolar molding (NAM) might help bring the parts of the lip closer together and improve the shape of the nose before the cleft lip repair. Cleft lip repair usually leaves a small scar under the nose. When Should I Call the Doctor? Cleft lip repair and other surgeries to help kids born with a cleft lip have greatly improved 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 (38.5°C) has lasting pain or discomfort has heavy bleeding from the mouth can't drink fluids What Else Should I Know? A baby with a cleft lip can sometimes have other health problems, such as: trouble feeding dental problems speech problems It's important to work with a care team experienced in treating children with cleft lip and palate. Besides the pediatrician, a child's treatment team will include: plastic surgeon ear, nose, and throat (ENT) physician (otolaryngologist) orthodontist dentist speech-language pathologist audiologist You might also work with: an oral surgeon a social worker a psychologist or therapist a geneticist a team coordinator Some children with cleft lip may need more surgeries as they get older. These might include: Alveolar (al-VEE-eh-lur) bone grafting: Doctors might use a small amount of bone from the hip to repair the cleft or notch in the gums and to support the permanent teeth as they come in. This surgery is usually done when kids are 7–9 years old. Nose surgery: Clefts of the lip also affect how the nose looks, so some kids may benefit from more surgery on the nose. Fixing minor problems, such as the shape of the nostrils, can be done during childhood. More extensive nose surgeries, if needed, are done when the child is finished growing. Orthognathic (or-thig-NATH-ik) surgery: Some children with cleft palate need this surgery to realign the jaws and teeth when they're older. It's done when the child is finished growing. Looking Ahead Most kids with cleft lip are treated successfully with no lasting problems. A team experienced in treating children with cleft lip and palate can create a treatment plan tailored to your child's needs. 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: American Cleft Palate-Craniofacial Association (ACPA) Cleft Lip & Palate Association FACES: The National Craniofacial Association Smile Train Back to Articles Related Articles Cleft Palate A cleft palate is when a baby is born with a cleft (gap) in the roof of the mouth. Most kids can have surgery to repair them early in life. Read More Cleft Palate With Cleft Lip A cleft palate with a cleft lip is when a baby's lip and palate (roof of mouth) don't form properly during pregnancy. Most kids with cleft lip and palate are treated successfully with no lasting problems. Read More Submucous Cleft Palate In a submucous cleft palate, the muscles of the palate don't form properly, but the tissue that lines the roof of the mouth does. This makes these clefts harder to see. Read More Speech-Language Therapy for Children With Cleft Palate Speech-language pathologists help kids with speech problems related to a cleft palate. Find out what they do. Read More Going to a Speech Therapist You might visit a speech therapist if you're having trouble speaking or understanding others. Find out more in this article for kids. Read More Middle Ear Infections (Otitis Media) Ear infections are common among kids and, often, painful. Find out what causes them and how they're treated. Read More Plastic Surgery Lots of images may come to mind when you think of plastic surgery. This special type of surgery involves a person's appearance and ability to function. Read More Speech Problems Do you know someone who stutters or has another speech disorder? Find out how speech disorders are treated, how you can help a friend or classmate cope, and lots more. Read More Birth Defects Some birth defects are minor and cause no problems; others cause major disabilities. Learn about the different types of birth defects, and how to help prevent them. Read More When Your Baby Has a Birth Defect If your child has a birth defect, you don't have to go it alone - many people and resources are available to help you. Read More Speech Impairments Factsheet (for Schools) What teachers should know about students with speech impairments, and what teachers can do to help them succeed in school. Read More Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995-2021 KidsHealth®. All rights reserved. Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.