Every year, thousands of babies are born in the United States with cleft lip and/or cleft palate—conditions that affect the shape and function of the upper lip, nose, and roof of the mouth.
“These are among the most common birth defects in the country, but with early intervention, children with cleft conditions can grow up healthy, confident, and fully capable of living normal lives,” says Dr. Steven Balandran, Northwest Oral & Maxillofacial Surgery Doctor and a volunteer with Uplift International, a nonprofit that provides free cleft lip and palate surgeries overseas.
The American Cleft Palate Craniofacial Association (ACPA) estimates that 6,000 to 8,000 children are born in the U.S. every year with cleft lip and/or palate.
Whether a cleft is detected before birth or discovered at delivery, timely treatment by a coordinated medical team—often led by oral and maxillofacial surgeons—can make all the difference.
“Early diagnosis and treatment are important to achieve optimal outcomes and correction of cleft lip and palate,” says the Children’s Hospital of Philadelphia. “The discovery of cleft lip and cleft palate while a baby is still in the womb allows both the family and the healthcare team to prepare, anticipate potential challenges and assemble appropriate resources to optimize the outcome for the newborn.”
In this article, we explore why early diagnosis and treatment are so important and how they help minimize complications, support healthy development, and improve long-term outcomes.
A cleft lip is a separation in the upper lip that can occur on one or both sides of the mouth. A cleft palate is a split or opening in the roof of the mouth, which may affect the hard palate (toward the front), soft palate (toward the throat), or both. These conditions can occur independently or together.
Cleft conditions develop early in pregnancy—typically in the first 6 to 10 weeks—when the tissue that forms the lip and palate doesn’t fully fuse. While genetics and environmental factors may play a role, many cases occur without a known cause.
“When a person is born with a cleft lip, it may appear that parts of the mouth are missing. In fact, a cleft lip occurs when the two sides of the face fail to join together very early in pregnancy,” explains the ACPA. “A cleft palate is an opening in the roof of the mouth that is present at birth.”
Cleft lip and cleft palate do not cause pain or bleeding.
Cleft lip and cleft palate are among the most frequently occurring birth differences in the United States:
(Source: Centers for Disease Control and Prevention)
These conditions can vary from mild to severe and require individualized treatment based on the child’s unique anatomy and needs.
Early care doesn't just address cosmetic concerns—it directly improves critical functions like breathing, feeding, hearing, and speaking. Here’s why getting started early is key:
✔️ Easier Feeding and Nutrition
Infants with cleft palate often struggle to create suction while nursing or bottle feeding, which can lead to poor weight gain. With early intervention:
✔️ Improved Speech Outcomes
The soft palate plays a vital role in producing clear speech. Delayed treatment increases the risk of:
Surgical repair of the palate, typically done between 9 and 18 months, sets the stage for better language development. Early therapy from a speech-language pathologist can further enhance outcomes.
✔️ Fewer Ear Infections and Hearing Loss
Cleft palate can lead to chronic ear infections and fluid buildup, which may cause:
Early ear tube placement, often done during cleft palate repair, helps prevent these issues.
✔️ Better Emotional and Social Wellbeing
Unrepaired cleft conditions can lead to bullying, isolation, and low self-esteem during a child’s early years. Early surgical correction allows the child to:
Oral and maxillofacial surgeons play a central role in cleft treatment, working closely with a multidisciplinary team that may include:
Usually, patients requiring cleft care in the United States (at least in developed are identified in utero or at the time of birth and are directed to specialty multidisciplinary “cleft clinics” for treatment along all the stages of treatment.
Treatment for cleft conditions is not a one-time fix — it often involves a carefully coordinated plan over several years. Below is a general timeline:
|
Age Range |
Intervention |
|
Birth–3 months |
Diagnosis, feeding support, initial consultations |
|
3–6 months |
Surgical repair of cleft lip |
|
9–18 months |
Surgical repair of cleft palate |
|
1–5 years |
Speech therapy, hearing evaluations, possible additional surgery |
|
6–10 years |
Bone grafting for gumline (alveolar bone graft) |
|
11–18 years |
Orthodontic treatment, jaw surgery if needed |
|
Adulthood |
Final cosmetic refinements or dental implants |
Every child’s journey is different, and the treatment plan is tailored to their needs.
While some families may hesitate due to fear, finances, or lack of access, postponing treatment can create lasting complications. Without early care, children with cleft conditions may experience:
“The earlier a cleft is addressed, the more seamless and successful the care pathway typically becomes,” says Dr. Balandran.
One of the most important advantages of early intervention is the ability to build a trusted care team from the beginning. The cleft team works together through every phase of growth and development to ensure:
Parents become part of this team too — helping to monitor milestones, reinforce therapies, and make informed decisions.
Based in The Woodlands, TX, our team at Northwest Oral & Maxillofacial Surgery has years of experience supporting families affected by cleft conditions from early childhood.
Cleft lip and/or palate conditions often require multiple surgeries which can affect the growth of the jaws due to scar tissue formation. This condition can be corrected with orthognathic surgery or surgical repositioning of the jaws. This surgery is typically completed once skeletal growth is finished in the mid to late teens.
“We believe that every child deserves the best start possible—and we’re here to help make that happen,” says Dr. Balandran.
If your child—or a child you know—has been diagnosed with a cleft lip or palate, early action is the most powerful step you can take. The earlier treatment begins, the smoother the path forward.
Contact Northwest Oral & Maxillofacial Surgery today to learn more about our post cleft surgery care services and schedule a consultation. Let us help you build a treatment plan that supports your child’s health, confidence, and future.