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Cleft Lip and Palate Awareness

publication date: May 8, 2017
author/source: Susannah Schaefer

girl with cured cleft lip

What is cleft and what are the causes? 

A cleft occurs when certain body parts and structures do not fuse together during foetal development. Clefts can involve the lip and/or the roof of the mouth, which is made up of both hard and soft palate. There is no medical consensus on what causes a cleft lip and/or palate. However, most experts agree that the causes of cleft are multifactorial and may include:

  • Genes inherited from a child’s parents
  • Drug and/or alcohol use during pregnancy
  • Smoking during pregnancy
  • Maternal illness or infections
  • Lack of nutrition and Vitamin B, also known as folic acid during pregnancy

Although these factors may act as an explanation for some, in many cases it is not known what causes a cleft lip and/or palate.

Complications associated with clefts 

Sadly, cleft defects are frequently overlooked as a cosmetic issue, but in reality, if left untreated, the condition can cause some serious health issues, including: • Difficulty eating • Difficulty breathing • Speech problems • Hearing Loss • Dental complications • General wellbeing

How is the condition diagnosed?

Cleft lip and palate can be picked up via ultrasound scan, as early as 18 to 21 weeks – this isn’t guaranteed though as some varieties of the condition can be difficult to detect. If a cleft isn’t picked up at this stage, then it will likely be picked up immediately after birth.


Cleft repair surgery is simple, and the transformation is immediate:

  • A cleft lip is usually repaired approximately three to six months after birth through surgery
  • A cleft palate is typically repaired between seven and 18 months of age through a procedure called "palatoplasy", which involves connecting the muscles of the soft palate and rearranging the tissues to close the cleft. Further treatments are often needed after surgery to treat associated symptoms; for example, Rhinoplasty, lip revision surgery, or speech therapy. In the UK, when a cleft lip or palate is diagnosed, parents will immediately be referred to a National Health Service (NHS) specialist and their child will have received corrective surgery within a year of being born.

However, unfortunately across much of the developing world it is a very different story. Many families in developing countries do not have access to quality healthcare services or the resources to pay for proper cleft treatment, which is why it is more common to see children with clefts in these countries.

In response to this global issue, my charity Smile Train works hard to provide training and education for local doctors and medical professionals in over 85 developing countries, to provide 100 per cent free cleft repair surgery and comprehensive cleft care within their own communities. As a result of this approach, Smile Train has been able to transform the lives of more than one million children, by giving them the power of a smile.