Serving patients with cleft lip and palate conditions since 1977, our nationally leading and multidisciplinary team knows how important it is to provide holistic care for your child. Speech and swallow therapists, audiologists, geneticists, orthodontists, plastic surgeons and otolaryngologists are involved throughout the process of diagnosis, treatment and therapy.

What Is Cleft Lip and Palate?

Cleft lip and palate are birth defects that affect the upper lip and roof of the mouth. The conditions can occur separately or together. 

  • Cleft lip: In the first six weeks of a typical pregnancy, the developing baby’s upper lip fuses together. If that fusion is not complete, it results in a split lip or cleft that can be as subtle as a notch in the upper lip or as severe as a split extending to the nose.  
  • Cleft palate: A baby’s palate, or the roof of their mouth, fuses by the second month of pregnancy. The palate includes both the soft, flexible tissue that spans the back of the mouth and the bony, hard palate that creates the shape of the roof of the mouth. The incomplete fusion of either palate results in a cleft palate, creating an opening to the nasal cavity inside the mouth.  

Causes of Cleft Lip and Palate

There are many causes of cleft lip and palate. Problems with genes passed down from 1 or both parents, drugs, viruses, or other toxins can all cause these birth defects. Cleft lip and palate may occur along with other syndromes or birth defects.

A cleft lip and palate can:

  • Affect the appearance of the face
  • Lead to problems with feeding and speech
  • Lead to ear infections

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.

The Team Approach to Cleft Care

The team approach of the Wake Forest Baptist Cleft and Craniofacial team is the absolute best way to make sure children like Matthew get all of their care needs met. 

Diagnosing Cleft Lip and Palate

A cleft lip can be detected during pregnancy through ultrasounds. A cleft palate is difficult to detect in prenatal ultrasounds and is usually diagnosed at birth.

Fortunately, as these conditions together are the fourth most common birth defects in the country, the treatments are now relatively straightforward, effective and safe.

Treatment of Cleft Lip and Palate

Treatments for cleft lip and palate conditions vary based on the severity of the condition and are highly individualized. Newborns are monitored in the first few weeks by a feeding specialist, pediatric dentist, speech pathologist and plastic surgeon. The team ensures the baby is feeding properly and gaining weight, and they also look for any complications that could cause long-term issues with hearing and speech. In fact, cleft palates should be treated within the first year of life to support proper speech development.

To treat cleft lip, the North Carolina Cleft and Craniofacial Center offers nasoalveolar molding, a nonsurgical treatment involving a custom retainer, placed by our pediatric dentist, to help align the baby’s gums and shape the nostrils prior to surgery to minimize the number of future surgeries.

Babies between two and six months can undergo surgery to close a cleft lip. While the first surgery can amend most of the abnormality, additional surgery may be needed later in life depending on the severity of the cleft.

At age three, children may begin attending formal cleft clinics annually where each specialist from the team will address any problems with hearing, speech, tooth and jaw growth, and other issues that arise during a general developmental assessment. Children are typically followed on an annual basis until age 18.