Baby Born with Cleft Lip or Palate
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published CDC, AAP, NIH guidelines
Last reviewed:
Your baby's physical development is unique, and concerns about baby born with cleft lip or palate, here is what you need to know.
The short answer
Cleft lip and cleft palate are among the most common birth differences, occurring in about 1 in 1,600 births. A cleft lip is an opening in the upper lip, while a cleft palate is an opening in the roof of the mouth. They can occur alone or together. With modern surgical repair and a supportive care team, most children with clefts go on to eat, speak, and develop normally. Surgical repair is typically done in the first year of life.
Key takeaways
- Cleft lip and cleft palate are among the most common birth differences, occurring in about 1 in 1,600 births. A cleft lip is an opening in the upper lip, while a cleft palate is an opening in the roof of the mouth. They can occur alone or together. With modern surgical repair and a supportive care team, most children with clefts go on to eat, speak, and develop normally. Surgical repair is typically done in the first year of life.
- Usually normal when: Difficulty with feeding in the early weeks before specialized bottles are provided
- Call your doctor if: Your baby is choking frequently during feeds or turning blue
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to CDC, AAP, NIH guidelines, cleft lip and cleft palate are among the most common birth differences, occurring in about 1 in 1,600 births. A cleft lip is an opening in the upper lip, while a cleft palate is an opening in the roof of the mouth. They can occur alone or together. With modern surgical repair and a supportive care team, most children with clefts go on to eat, speak, and develop normally. Surgical repair is typically done in the first year of life. At Newborn, a cleft lip is visible at birth and is usually detected during delivery or on prenatal ultrasound. A cleft palate may not be immediately visible and is sometimes discovered when feeding difficulties arise. The immediate priority is establishing feeding, as babies with cleft palate often cannot create the suction needed for breastfeeding or standard bottle feeding. Specialized bottles (like the Pigeon or Dr. Brown's Specialty Feeding System) can help. A cleft team referral is typically made within the first days of life. It is generally considered normal when difficulty with feeding in the early weeks before specialized bottles are provided. However, you should contact your pediatrician promptly if your baby is choking frequently during feeds or turning blue.
Normal vs. Concerning
By Age
What to expect by age
Newborn
A cleft lip is visible at birth and is usually detected during delivery or on prenatal ultrasound. A cleft palate may not be immediately visible and is sometimes discovered when feeding difficulties arise. The immediate priority is establishing feeding, as babies with cleft palate often cannot create the suction needed for breastfeeding or standard bottle feeding. Specialized bottles (like the Pigeon or Dr. Brown's Specialty Feeding System) can help. A cleft team referral is typically made within the first days of life.
0-6 months
Cleft lip repair surgery is usually performed between 3-6 months of age. Before surgery, the focus is on weight gain and feeding support. Some babies may use a nasoalveolar molding (NAM) device to help shape the lip and nose before surgery. Breastfeeding may be possible with a cleft lip alone, but cleft palate usually requires specialized feeding techniques. Ear infections are more common in babies with cleft palate, so hearing will be monitored.
6-18 months
Cleft palate repair surgery is typically done between 9-14 months of age, before speech begins developing. After palate repair, feeding transitions to normal bottles and cups. Speech therapy evaluation usually begins around 12-18 months. Most children develop normal or near-normal speech with appropriate support. Additional surgeries may be needed as the child grows, but the major repairs happen in the first year.
What to Tell Your Pediatrician
- Describe when you first noticed baby born with cleft lip or palate and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby is not gaining weight despite using specialized feeding techniques.
- Mention if your baby has frequent ear infections or fluid buildup in the ears.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Difficulty with feeding in the early weeks before specialized bottles are provided
- Milk coming out of the nose during feeding before palate repair
- A wide or obvious gap in the lip or palate at birth
- Needing specialized feeding equipment like squeezable bottles
- A visible scar after cleft lip repair that fades over time
- Your baby is not gaining weight despite using specialized feeding techniques
- Your baby has frequent ear infections or fluid buildup in the ears
- You have questions about surgical timing, feeding strategies, or speech development
- You want a referral to a cleft palate team if one has not been arranged
- Your baby is choking frequently during feeds or turning blue
- Your baby has a fever or signs of infection after surgery
- Your baby has significant breathing difficulty
- Your baby is not producing wet diapers or shows signs of dehydration from feeding difficulty
What You Can Do at Home
- Keep track of when you notice baby born with cleft lip or palate — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that difficulty with feeding in the early weeks before specialized bottles are provided — this is generally within the range of normal.
- At Newborn, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Provide plenty of supervised floor time and tummy time to support your baby's physical development.
- While monitoring at home, seek immediate care if your baby is choking frequently during feeds or turning blue.
Related Conditions
I'm Worried My Baby Is Aspirating During Feeds
Aspiration means liquid or food enters the airway instead of the stomach. Occasional coughing during feeds is common and does not usually indicate aspiration. True aspiration is less common and may present as recurrent respiratory infections, a wet or gurgly voice after feeds, or chronic cough. If you are concerned, a swallow study can provide a definitive answer.
Slow Weight Gain in Breastfed Baby
Weight gain patterns vary among babies, and breastfed babies often grow differently than formula-fed babies - they tend to gain more quickly in the first three months and then more slowly from three to twelve months. This is normal and is reflected in the WHO growth charts. However, if your baby is consistently gaining less than expected or has dropped significantly on their growth curve, it is important to work with your pediatrician and possibly a lactation consultant to identify the cause and ensure your baby is getting enough milk.
Speech Delay in My Child
Speech delay means a child is developing speech and language skills in the expected order but at a slower pace than typical. It's one of the most common developmental concerns - affecting about 10-15% of toddlers - and early intervention through speech therapy is remarkably effective, with many children catching up fully by school age.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is baby born with cleft lip or palate normal?
When should I call the doctor about baby born with cleft lip or palate?
When is baby born with cleft lip or palate normal?
What causes baby born with cleft lip or palate?
What should I mention to my pediatrician about baby born with cleft lip or palate?
Is baby born with cleft lip or palate normal at Newborn?
Is baby born with cleft lip or palate normal at 0-6 months?
Should I go to the ER for baby born with cleft lip or palate?
Does baby born with cleft lip or palate go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Baby Born with Cleft Lip or Palate.
Things to mention
- Describe when you first noticed baby born with cleft lip or palate and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby is not gaining weight despite using specialized feeding techniques.
- Mention if your baby has frequent ear infections or fluid buildup in the ears.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your baby is not gaining weight despite using specialized feeding techniques
- Your baby has frequent ear infections or fluid buildup in the ears
- You have questions about surgical timing, feeding strategies, or speech development
Urgent signs to report immediately
- Your baby is choking frequently during feeds or turning blue
- Your baby has a fever or signs of infection after surgery
- Your baby has significant breathing difficulty
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of baby born with cleft lip or palate are normal. Talk to your pediatrician if your baby is choking frequently during feeds or turning blue.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Physical Concerns
I'm Worried My Baby Is Aspirating During Feeds
Aspiration means liquid or food enters the airway instead of the stomach. Occasional coughing during feeds is common and does not usually indicate aspiration. True aspiration is less common and may present as recurrent respiratory infections, a wet or gurgly voice after feeds, or chronic cough. If you are concerned, a swallow study can provide a definitive answer.
Slow Weight Gain in Breastfed Baby
Weight gain patterns vary among babies, and breastfed babies often grow differently than formula-fed babies - they tend to gain more quickly in the first three months and then more slowly from three to twelve months. This is normal and is reflected in the WHO growth charts. However, if your baby is consistently gaining less than expected or has dropped significantly on their growth curve, it is important to work with your pediatrician and possibly a lactation consultant to identify the cause and ensure your baby is getting enough milk.
Speech Delay in My Child
Speech delay means a child is developing speech and language skills in the expected order but at a slower pace than typical. It's one of the most common developmental concerns - affecting about 10-15% of toddlers - and early intervention through speech therapy is remarkably effective, with many children catching up fully by school age.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
Baby-Proofing a Small Apartment
Baby-proofing a small apartment is absolutely possible and focuses on the same key safety principles as any home: securing furniture to walls, covering outlets, locking cabinets with hazardous materials, and ensuring safe sleep spaces. Small spaces actually have an advantage - there is less area to monitor. Focus on eliminating the most dangerous hazards first: falls, poisoning, choking, and burns.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.