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 What is a Cleft Lip?

patient before surgery, afterA cleft is an opening or gap in the lip, and sometimes the gum. The cleft can be on one side or both sides. A cleft lip can extend into the nose or stop at any point below.   

Having a cleft lip of any type also changes the shape of the nostril.  When there is a cleft through the gum, certain teeth may be affected.  Sometimes there is a missing tooth or an extra tooth near the cleft, and most children will need braces later.

Cleft lip occurs during the first trimester of pregnancy, often before a woman knows she is pregnant. It is one of the most common birth differences in the USA. About one in every 550 babies is born with a cleft of the lip, palate, or both.

What Causes Cleft Lip?

In about two thirds of children, there is no known cause for their cleft. Sometimes, clefts may run in families, or may be associated with other problems and may be part of a syndrome. A syndrome is a disorder that has a recognized group of symptoms or features. We have learned there are many things that can increase the chances of a baby having a cleft, but more still needs to be learned through scientific research.

photoIs Feeding Difficult For Babies With Cleft Lip?

Babies with cleft lip should not have any problems with feeding, whether bottle feeding or breastfeeding. Breast feeding is especially helpful for babies with cleft lips. You may need to try different positions to determine which is easiest for your baby to nurse. A lactation consultant may be helpful.

A baby with a cleft may also swallow more air while feeding. Burping your baby more frequently ensures the baby is comfortable. For more information about feeding your baby learn about the Center's Feeding Consultation Services.

Do You Recommend the Use of Orthopedic Devices for Babies with Cleft Lip?

At our Center, every child has an individualized treatment plan developed with the family.  We do not routinely recommend the use of orthopedic devices, such as Latham appliances or naso-alveolar molding (NAM). These devices are expensive, labor intensive for families, and have not been proven to have a long term benefit to children. Sometimes we recommend gentle taping of the lip at our first evaluation after the baby is born. If it will benefit your baby, we will give you the tape and teach you how to apply it.

How is Cleft Lip Treated?

A baby born with cleft lip will need surgery to correct this condition.  Our team recommends that every baby with cleft lip be evaluated while in the hospital, or as soon as possible after going home. The surgeon will determine the earliest and safest time for lip repair. We repair the baby’s nose at the same time. A special closure technique is used so there are no stitches that will need to come out.  Our babies feed the same way before and after the operation, so you will not have to make any changes in your baby’s feeding.  We do not use any arm restraints (“No-No’s), or protective facial appliances. Babies are usually discharged the same day as the surgery and do not need to spend the night in the hospital.  We encourage families to call us with any questions or concerns.

Taking care of a child with a cleft lip is more than just performing a surgical procedure. Having a cleft lip can affect a child’s appearance, self esteem, teeth, and speech. This is why all children with a cleft lip are followed regularly by our multidisciplinary team. Experts dedicated to the care of children with craniofacial conditions from a wide range of pediatric specialties work together to make sure your child gets the best care possible.