Cleft Palate

A cleft palate is a gap or split in the roof of the mouth (the palate). It occurs when the palate of a fetus does not develop properly during the first months of pregnancy.

Mixed Feelings

Tonya and Phil were excited to hear their newborn son's first cry, but they were shocked when they saw him for the first time. Baby Philip's upper lip was split up the middle. The doctor told them that Philip had a cleft palate as well as a cleft lip and that both are fairly common birth defects (known by the medical term, orofacial cleft). The doctor reassured Philip's parents that their son was otherwise a healthy baby. The cleft lip and palate would cause Philip some problems, but none that could not be overcome. A plastic surgeon would repair Philip's lip and palate, and a team of specialists would work on related problems with his teeth, ears, and speech.

The United States and the World

What Is a Cleft Palate?

Cleft means gap or split, and the palate is the roof of the mouth. A cleft palate occurs when the roof of the mouth in a fetus * does not develop properly, leaving a hole between the nose and the mouth.

The palate extends from the top teeth to the uvula (VOOV-u-la), which is the little piece of tissue that hangs in the back of the throat. A bony hard palate can be felt just behind the top teeth, and a muscular soft palate is located just behind the hard palate. A fully formed palate is necessary to close off the nose and throat from the mouth. It keeps food from going up the nose, and it pushes food and saliva to the back of the throat when a person is eating and swallowing. The palate also is important for speaking because it keeps air from going out of the nose instead of the mouth.

A cleft palate is a gap or split in the roof of the mouth (palate). The palate fuses closed as a normal part of fetal development (left).

A cleft palate is a gap or split in the roof of the mouth (palate). The palate fuses closed as a normal part of fetal development (left). If the palate does not fuse correctly, it can result in a partial cleft palate (middle), or a complete cleft palate and cleft lip (right).
Illustration by Frank Forney. © 2016 Cengage Learning®.
Operation Smile

Cleft palate repair requires multiple surgeries, and many people do not have access to or money for the needed medical care. In 1982, plastic surgeon William P. Magee and his wife Kathleen, a nurse and social worker, founded Operation Smile to help make a difference.

Operation Smile and its volunteers provide free reconstructive (repair and rebuilding) surgery and other medical services for children in the United States and in 20 developing countries. Operation Smile volunteers have treated more than 220,000 children since 1982. Even so, many children go untreated, which can lead to medical complications later in life.

Why Are Babies Born with Cleft Palates and Cleft Lips?

Cleft palates and lips probably are the result of a number of factors acting together. One in five cases is inherited, probably through the interaction of many different genes * . In most cases, however, clefts seem to result from environmental factors to which the fetus is exposed early in gestation. The German measles (rubella) virus, other infections, vitamin deficiencies, some medications, and maternal alcohol and drug use during pregnancy all seem to increase the risk that a child will be born with a cleft lip or palate. Prevention efforts are focused on teaching people about these risk factors regarding pregnancy.

What Happens to Children with Cleft Palate and Cleft Lip?

Symptoms An improperly formed palate or upper lip affects a child's physical and emotional health in many different ways:

Surgically repaired cleft palate.

Surgically repaired cleft palate.

Fixing Philip's cleft lip and palate requires several surgeries, the first two of which occurred during the baby's first year. In the first surgery when Philip is three months old, a plastic surgeon repairs the lip by stitching together its edges using flaps of skin from other parts of Philip's mouth. In the second surgery when Philip is six months to a year old, the surgeon repairs the cleft palate. If Philip is prone to ear infections, the doctor puts tubes in the baby's ears to help drain them of the fluid that otherwise may lead to infection. These repairs, which are done as early as possible, help prevent hearing and speech problems.

Philip also may require several cosmetic surgeries to adjust his facial features as he grows older. He may need dental work to encourage jawbone growth and to straighten his teeth. He will have his hearing checked frequently by a hearing specialist (an audiologist), and he will need to work regularly with a speech therapist to learn how to train his palate muscles to work properly.

Philip and his parents will have a lot to deal with over several years, but his prognosis is good. The doctor expects that when Philip enters first grade, he will be speaking well, and he will have barely a scar where his cleft lip once was.

Not all children are as lucky as Philip, who had good medical coverage. Many other children in the United States and elsewhere in the world do not, which leaves a great number of children with no access to medical care. Without proper treatment, cleft palate and cleft lip can lead to myriad health, social, and emotional challenges, and these birth defects can also limit an individual's ability to become a productive member of society. Medical professionals and other advocates often point to this treatable condition as a strong argument for universal healthcare coverage.

See also Birth Defects: Overview • Genetic Diseases: Overview • German Measles (Rubella) • Growth and Growth Disorders • Pregnancy • Substance Abuse


Books and Articles

Losee, Joseph, et al. Comprehensive Cleft Care: Family Edition. London: CRC Press, 2015.

Schonborn, Karl. Cleft Heart. Clearfield, UT: Wayman Publishing, 2013.


Centers for Disease Control and Prevention. “Birth Defects.” (accessed November 28, 2015).


American Speech-Language-Hearing Association. 2200 Research Blvd., Rockville, MD 20850-3289. Toll-free: 800-638-8255. Website: (accessed November 28, 2015).

Cleft Lip and Palate Association. First Floor, Green Man Tower, 332B Goswell Rd., London EC1V 7LQ, United Kingdom. Telephone: 020-7833-4883. Website: (accessed November 28, 2015).

Cleft Palate Foundation. 1504 E. Franklin St., Suite 102, Chapel Hill, NC 27514-2820. Telephone: 919-933-9044. Website: (accessed November 28, 2015).

Operation Smile. 3641 Faculty Blvd., Virginia Beach, VA 23453. Telephone: 757-321-7645. Website: (accessed November 28, 2015).

* fetus (FEE-tus) is the term for an unborn human after it is an embryo, from nine weeks after fertilization until childbirth.

* genes (JEENS) are chemical structures composed of deoxyribonucleic acid (DNA) that help determine a person's body structure and physical characteristics. Inherited from a person's parents, genes are contained in the chromosomes found in the body's cells.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)