Openings in the Upper Lip and Roof of the Mouth (Cleft Lip and Cleft Palate) in Newborns: What to Know

Some babies are born with a small opening in their lip or the roof of their mouth. This is called a cleft lip or a cleft palate.

A cleft lip is a gap or split in the top lip. The cleft may be on one side of the face or both sides. A cleft palate is an opening in the roof of the mouth.

A baby can be born with a cleft lip, a cleft palate, or both.

What are the causes?

• A cleft lip happens when the lip doesn't close all the way. It can be a small gap or a bigger opening that goes up into the nose.
• A cleft palate happens when the roof of the mouth doesn't close. The front, back, or both parts may be open.

If the cleft lip and cleft palate are part of a syndrome, your baby may have other health problems too.

What increases the risk?

• Family history. If someone in your family had a cleft, your baby may have a higher chance too.
• Genetic conditions. Some babies are born with other conditions that include a cleft.
• The mother having diabetes before pregnancy.
• The baby being exposed during pregnancy to:
  • Certain medicines, like some used for seizures.
  • Alcohol or drugs.
  • Nicotine.

What are the signs or symptoms?

• Trouble feeding.
• Trouble breathing.
• Frequent ear infections.

How is this diagnosed?

A cleft lip and palate may be found during an ultrasound before birth. They may also be diagnosed at birth or during a physical exam shortly after birth.

How is this treated?

• A few months after birth for a cleft lip.
• When your baby is 9–18 months old for a cleft palate.

The repair will make it easier for your baby to eat and breathe. Depending on your baby's condition, your baby may have some treatments before 6 months of age, then other treatments when they're older. Some children may need more surgeries later in life.

Even though repairing the cleft will help with speech, language, and hearing development, your baby's health care team may also have specialists in these areas.

Follow these instructions at home:

Feeding

• If you're breastfeeding your baby, talk with a lactation specialist who can help you with:
  • How to hold your baby during feeding.
  • Ways for your baby to make a better lip seal on the breast.
  • Keeping your milk supply strong.
  • Pumping milk to feed your baby.
• If you're bottle-feeding, work with a feeding specialist who can help you with:
  • How to hold your baby during feeding.
  • Finding which type of bottle may work best for your baby.
  • Ways to make a better lip seal on the nipple.
  • Pacing feedings so your baby can drink slowly.

General instructions

• Give your child medicines only as told.
• Work closely with your child's team of health care providers. Reach out to them if you have questions.
• Keep all follow-up visits. This is important to make sure your baby is drinking enough milk and gaining weight.

Where to find more information

1. Go to cdc.gov.
2. Click "Search" and type "cleft lip."
3. Find the link you need.

Contact a health care provider if:

• Your baby isn't feeding well.
• Your baby doesn't gain weight or loses weight.
• Your baby cries more than usual, especially when lying down.
• Your baby pulls or rubs their ear a lot.
• Your baby doesn't startle at loud sounds or doesn't react to sounds like they used to.

• Your baby is younger than 3 months old and has a temperature of 100.4°F (38°C) or higher.
• Your child is 3 months old or older and has a temperature of 102.2°F (39°C) or higher.
• Your child has a fever, and they look or act sick in a way that worries you.

If you can't reach the provider, go to an urgent care or emergency room.

Get help right away if:

• Your child is having trouble breathing.
• Your child is unable to feed.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Call 911 right away.