Cleft Lip and Cleft Palate

A child with a cleft lip or palate can have feeding and speech problems. Speech-language pathologists, or SLPs, can help.

On this page:

About Cleft Lip and Palate
Causes of Cleft Lip and Palate
The Cleft Lip and Palate Team
Testing Hearing and Speech
Treatment for Cleft Lip and Palate
Other Resources

About Cleft Lip and Palate

“Cleft” means “split,” so a cleft lip is a split in the lip. A cleft palate is an opening in the front part of the roof of the mouth. This front part is called the bony hard palate. The back part is the soft palate, which is made of muscle.

Cleft lips and palates develop during pregnancy. Cleft lip and palate can also affect adults, especially if the condition isn’t noticed and isn’t treated in childhood.

A person can have a cleft lip, cleft palate, or both. A cleft lip may be on one or both sides of the upper lip. The split may also be in the upper jaw and gum.

Clefts can happen anywhere on the palate or lip. A person can also have a submucous, or hidden, cleft palate. This happens when tissue, called the mucous membrane, covers the cleft. It is the pink tissue that you see in your mouth. The cleft may be hard to see, and you may not know it is there

Causes of Cleft Lip and Palate

Clefts happen to a baby very early in the mother’s pregnancy, and the cause is unknown. Some possible risk factors include

genetics,
smoking during pregnancy,
diabetes during pregnancy,
using drugs or alcohol during pregnancy,
taking some medicines while pregnant, and/or
poor prenatal health care.

The Cleft Lip and Palate Team

People with cleft lip and palate usually need help from a cleft palate and/or craniofacial team. This team may include a(n)

audiologist;
dentist;
dietitian or nutritionist;
ear, nose, and throat doctor (ENT);
nurse;
orthodontist;
plastic surgeon;
SLP; and/or
social worker.

Find a team near you by visiting the American Cleft Palate Craniofacial Association website.

Testing Hearing and Speech

Testing for speech and/or hearing issues because of cleft lip and palate is usually done by a team in a health care setting. Physicians and other medical professionals work together with the family to find out (a) what kind of cleft it is; (b) if speech, hearing, and feeding are affected; and (c) what types of services may help.

Speech testing is sometimes done in early childhood when a child’s speech difficulties are first noticed. An SLP can assess articulation to determine if the child may possibly have a cleft palate.

Testing may also include hearing tests done by an audiologist. This is important if the child has frequent ear infections or has extra fluid in the ears (this happens a lot to people who have a cleft palate). An audiologist may monitor the hearing status of a person with cleft lip and palate, especially from birth to age 6.

Treatment for Cleft Lip and Palate

Although cleft lip palate is often addressed with surgery and dental and orthodontic care, the medical team supports any additional feeding, speech, or hearing problems.

SLPs work with people on feeding and swallowing skills. Babies with a cleft lip probably won’t have trouble feeding, but babies with a cleft palate might. Babies with a cleft palate may have trouble breastfeeding, and they may need special bottles or nipples if they bottle-feed. SLPs can help you find the best bottle-and-nipple combination. Physicians and the rest of the team will also watch growth and nutrition. Learn more about feeding and swallowing problems in children and feeding and swallowing in adults.

SLPs also work with people on speech problems. Cleft lip may not create any speech problems, but a person with cleft palate may need help learning to speak more clearly.

Audiologists manage hearing and balance problems. The audiologist will work with the physician to make sure that hearing loss is identified and addressed, if needed. Audiologists may help you to use amplification (like hearing aids) or other hearing technology.