Understanding Cleft Palate and Cleft Lip

Cleft Palate and Lip Overview
Cleft palate and cleft lip occur when tissues in the baby's face and mouth do not form properly. A cleft, or separation of the upper lip and or the roof of the mouth, occurs very early in the development of young unborn child.
Normally, in the second and third months of pregnancy the tissues that make up the palate and lip fuse together. But in babies where this fusion does not happen or fuses only partially, an opening (cleft) is the result.

The incomplete formation of the upper lip or the roof of the mouth can occur individually, or both defects may come together. The condition(s) can vary in severity and may involve one side, unilateral, or both sides, bilateral.

Cleft palate and cleft lip are among the most common birth defects affecting children the United States, occurring in one in 600 births, according to the Cleft Palate Foundation (CPF).

A cleft palate and cleft lip may be detected on fetal ultra sound at about 18-20 weeks. An ultrasound is a test that uses sound waves to create pictures of the developing fetus. When analyzing the pictures, the doctor may detect an abnormality in the facial structures.

Pregnancy and Delivery
After your initial ultrasound, you will be referred by your obstetrician or perinatologist to the craniofacial surgeon, craniofacial nurse, and fetal medicine nurse coordinator for consultation. The team will then develop a care plan for your baby.

You will continue to have ultrasounds throughout your pregnancy to follow your baby’s growth.

Treatment and Surgery
Once your baby is born, the hospital where you deliver will notify Children's Hospital Oakland's Craniofacial Clinic. Children's Craniofacial Nurse Specialist is available to help if your baby is having any difficulty feeding. Your pediatrician will examine your baby and as long as your child is feeding and gaining weight your he or she will be able to go home with you.

An appointment for your baby to be seen by Children's Craniofacial Baby Panel will be scheduled as soon as possible.

  • A cleft lip is repaired when the child is between 3-5 months of age.
  • A cleft palate is repaired when the child is 10-12 months of age.
Most cleft palate and cleft lip conditions can be repaired through specialized plastic surgery techniques to repair the defect and therapies to improve any related conditions. The goals of treatment for cleft lip and cleft palate are to improve the child's ability to eat, speak, hear and breathe and to achieve a normal facial appearance. 


Children's Hospital Oakland Craniofacial Baby Panel
Early intervention by a team of specialists is extremely important. Children's team is headed by Bryant Toth, MD. Dr. Toth is a reconstructive and plastic surgeon with over 25 years of experience in repairing cleft lip and cleft palate birth defects.

Craniofacial Baby Panel Specialist Team

Please contact the Children's Hospital Oakland's Craniofacial Clinic with any questions at 510-428-3150.

Children's Hospital Oakland's Craniofacial Nurse Specialist
For questions regarding feeding you may email Children's Hospital Oakland's Craniofacial Nurse Specialist directly at


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Understanding Cleft Palate and Cleft Lip