Cleft Palate: Causes, Risk Factors, Symptoms and Treatments

Commonly asked questions about cleft palate:

What Is Cleft Palate?

Cleft palate and cleft lip, also known as orofacial clefts, are openings or splits in the upper lip, roof of the mouth, or both. These conditions occur when the developing facial structures in an unborn baby are unable to close all the way.

Cleft lip and palate are two of the most common birth defects. Most of the time they occur as isolated birth defects, but they can be associated with many different inherited genetic conditions and syndromes.

What Causes Cleft Palate?

The cause of most orofacial clefts is unknown. However, many researchers believe that most cases of cleft lip and palate are caused by the interaction of genetic and environmental factors, such as environmental conditions the mother is exposed to while pregnant. These potential factors include the mother’s eating or drinking habits, or certain medications that she may use during pregnancy.

What Risk Factors Are Attributed To The Development Of Cleft Palate?

According the the Center for Disease Control and Prevention, research studies have found several factors that increase the chance of having a baby with an orofacial cleft. These factors include:

  • Smoking: Women who smoke while they are pregnant are more likely to have a baby with an orofacial cleft.
  • Diabetes: Compared to women without diabetes, those who have been diagnosed with diabetes before pregnancy have an increased chance of giving birth to a child with an orofacial cleft.
  • Use of Certain Medications: Women who have used certain medications to treat epilepsy, such as topirmate or valporic acid, during the first three months of pregnancy are more likely to have a baby with an orofacial cleft. Additionally, women who used Zofran to treat morning sickness may increase the risk of having a baby born with a cleft palate.

What are the Criteria for Filing a Zofran Lawsuit?

Manufactured by GlaxoSmithKline, Zofran (ondansetron) was approved to treat nausea during chemotherapy and following surgery.

Zofran (ondansetron) works by blocking serotonin in the areas of the brain that trigger nausea and vomiting.

Between 2002 and 2004, GSK began promoting Zofran off-label for the treatment of morning sickness during pregnancy, despite the fact the drug has not been approved for pregnant women and there have been no well controlled studies in pregnant women.

The FDA has received nearly 500 reports of birth defects linked to Zofran. Birth defect risks include cleft palate and septal heart defects.

What Signs/Symptoms Are Associated With A Cleft Palate?

There are several different signs and symptoms to look for when determining if your child has a cleft palate. The Mayo Clinic reports that the most obvious signs that your child has an orofacial cleft are:

  • A split in the lip and roof of the child’s mouth that affects one or both sides of their face.
  • A split in only the lip that can appear either as a small notch, or an extended slit from the lip through the upper gum and roof of the mouth into the bottom of the nose.
  • A split in the roof of the mouth that does not affect the appearance of the face.
Although it is far less common, it is possible that the cleft can occur in the muscles of the soft palate, which are located in the back of the mouth and are generally covered by the mouth’s lining. This form of orofacial cleft often goes unnoticed and may not be diagnosed until much later when signs start to develop. The signs and symptoms to look for in this form of cleft are:
  • Feeding difficulty
  • Difficulty swallowing, with the potential for liquids and foods to come out of the nose.
  • Nasally speaking voice
  • Chronic ear infections

Is Cleft Palate Fixable?

Yes, both cleft palate and cleft lip are fixable.

What Procedures And Treatments Are Used To Fix Cleft Palate?

The surgery that is used to fix orofacial clefts are performed in a hospital by a team of specialists. Your child will receive a mild anesthetic, so they will not be awake or feel any pain during the procedure. Mayo Clinic states that there are several different surgical techniques and procedures that doctors use to repair orofacial clefts, which include:

  • Cleft Lip Repair: In order to close the separation in the lip, the surgeon makes an incision on both sides of the cleft to create flaps of tissue. The tissue is then used to fill in the gap by stitching them together. This procedure should provide a normal lip appearance, structure and function. During this procedure the surgeon will also begin initial nasal repair if necessary.
  • Cleft Palate Repair: There are a number of different procedures that can be used to close the separation and rebuild the roof of the mouth, which includes both the hard and soft palate, depending on the child’s situation. The surgeon makes an incision on both sides of the cleft and re-positions the tissue and the muscles. The incision is then stitched closed.
  • Ear Tube Surgery: For children who have a cleft palate, ear tubes may need to be placed. Usually these tubes are placed at around 6 months of age and are used to reduce the risk of chronic ear fluid, which can to lead to hearing loss. The ear tube surgery involves placing a tiny tube into the eardrum to create an opening that prevents fluid build up.
  • Surgery To Reconstruct Appearance: Additional surgeries may be needed to help improve the appearance of the mouth, lip and nose.

A surgery can greatly improve your child’s quality of life and appearance, as well as their ability to eat, breathe and talk. However, as with all forms of surgery, there are potential risks involved. These risks include bleeding, poor healing, the puckering of scars, and temporary or permanent damage to nerves, blood vessels and other structures.

Treatment of Complications

Your medical professional may recommend additional treatment for any complications that are caused by the orofacial cleft, such as:

  • Feeding strategies, such as using a special bottle or feeder
  • Speech therapy to correct any difficulty that they may have with speaking
  • Orthodontic adjustments to teeth and the bite, similar to having braces
  • Monitoring by a pediatric dentist for tooth development and oral health from an early age
  • treatment and monitoring for ear infection, which may lead to the implementation of ear tubes
  • Hearing aids or other assistive devices for a child suffering from hearing loss

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View Sources

  1. Center for Disease Control and Prevention — Facts about Cleft Palate and Cleft Lip
  2. Mayo Clinic — Cleft Palate Symptoms and Signs 
  3. Mayo Clinic — Cleft Palate Treatments


Grayson B, Santiago P, Lawrence B, Cutting C, Presurgical Nasoalveolar Molding in Infacts with Cleft Lip and Palate, 1999, The Cleft Palate-Craniofacial Journal, 36(6), 486-498

Smith D, Losee J, Cleft Palate Repair, 2005, Clinic is Plastic Surgery, Vol.41(2), 189-210