What Are Cleft Lips and Cleft Palates? Causes, Treatment, and Support
What every family should know after a prenatal or newborn cleft diagnosis — and why a cleft is no one’s fault.
Introduction
A cleft lip or cleft palate diagnosis often leaves families with more questions than answers: What caused the cleft? Did I do something wrong? Will my child be okay?
The truth is a cleft is no one’s fault. A cleft lip or cleft palate is a natural birth difference that develops early in pregnancy. In most cases, doctors cannot identify a single cause.
What is a cleft lip, and what is a cleft palate?
A cleft lip is an opening or separation in the upper lip that forms before birth. A cleft palate is an opening or separation in the roof of the mouth. A baby may be born with a cleft lip, a cleft palate, or both.
Clefts develop very early in pregnancy — typically between the sixth and the eleventh week, when the tissues that form the lip and palate usually join together.
About one in every 700 babies is born with a cleft around the world, making clefts among the most common birth differences. They can affect feeding, hearing, speech, dental development, and facial growth if left untreated. Fortunately, decades of research and medical advances have shown that these challenges can be successfully managed through comprehensive care.
Comprehensive cleft care means treating the whole child — not just the cleft itself. It can last from birth through adulthood and may include surgery, feeding support, speech therapy, dental and orthodontic treatment, ear and hearing care, nutrition support, and psychosocial services, all provided by a multidisciplinary team working in close coordination with one another, the patient, and their family.
The results of this approach speak for themselves. In 2025 alone, Smile Train supported:
- 94,461 cleft surgeries across 77 countries
- 131,886 non-surgical cleft interventions, including:
- 25,769 nutritional interventions
- 80,214 speech interventions
- 25,903 orthodontic interventions
- 34,619 hours of training delivered to 2,473 healthcare providers
Access to this kind of care has typically been rare in developing countries. That’s why Smile Train works with local medical professionals around the world, empowering them to sustainably provide the full range of services their patients need to thrive throughout their lives, close to home.
Learn more: How Smile Train goes beyond cleft surgery to build global surgical systems
What causes a cleft lip or cleft palate during pregnancy?
“Did I cause my baby’s cleft?”
It’s one of the first questions many parents ask when they receive a cleft diagnosis. No matter who you are or where you live, the answer is always the same:
No.
Scientific research confirms that clefts usually result from a complex combination of genetic and environmental factors. While family history, maternal smoking and drug use, certain medications, diabetes, or inadequate folic acid intake may increase the likelihood of a cleft developing, in most cases, doctors cannot identify one specific cause of any given cleft.
Unfortunately, many families still encounter myths that suggest otherwise. Depending on where they live, mothers may hear that their child’s cleft was caused by a curse, bad luck, a lunar eclipse, or evil spirits; that it’s due to something she ate, thought, or did during pregnancy; or that it’s a punishment for “bad” actions.
Though false, these myths have caused families, and mothers in particular, to be discriminated against and ostracized. Instead of seeking medical help for their babies, these women often blame themselves and internalize fear, shame, and stigma that can last for generations.
Replacing myths with facts is one of the most powerful ways to reduce stigma and encourage families to seek medical care.
Can a baby with a cleft lip or cleft palate live a healthy life?
Yes.
With appropriate treatment and support, babies born with cleft lips or cleft palates can grow up to live full, healthy lives. A cleft does not affect a child’s intelligence, personality, talent, or potential.
In the first weeks and months after birth, some babies with cleft palates may require additional support with feeding. As they grow, all will need one or more surgeries to close their cleft. Many will also require speech therapy, dental care, orthodontic treatment, ear and hearing care, or other specialized support to develop the skills and confidence they need to participate fully in school and family and community life.
No matter where their treatment journey takes them, with appropriate, timely medical care and support, children with clefts can grow up to achieve their dreams.
Nazareno: Strength, Discipline, Smiles
While bullying gives many children with clefts self-esteem issues, it inspired Nazareno to learn taekwondo. He recently placed second in the Junior Taekwondo World Cup.
Can people with clefts learn to speak clearly?
Yes. With timely treatment, most people with clefts can develop clear, understandable speech.
Speech is one of the most common concerns families have after a cleft diagnosis, and for good reason. The palate plays an important role in producing many speech sounds. When it is affected by a cleft, air can escape through the nose instead of the mouth, making certain sounds difficult to produce.
Yet surgically closing the palate is usually not enough to resolve speech differences. That requires regular play, practice, and personalized therapy with a specially trained speech therapist. Through a targeted treatment plan and working alongside caregivers, these professionals help children learn how to use their healed palate effectively and develop clear speech.
Timing is key. Because children learn language rapidly during their first few years of life, receiving speech evaluations and therapy at the soonest possible time can have a lifelong impact on communication, confidence, and mental health.
That’s why Smile Train has been working for over 20 years to expand access to these services. As of 2026, these efforts have brought comprehensive, cleft-specialized speech care to more than 30 countries, with more healthcare centers and providers receiving certification each year.
Harkirat Singh Paras: From Quiet Kid to Renaissance Man
Born with a cleft, Harkirat never spoke more than he absolutely had to until he was 18. Now this Smile Train patient is an entrepreneur, photographer, public speaker, and successful singer!
Learn more: How Smile Train supports cleft-specialized speech therapy programs around the world
Why is cleft awareness important?
Medical care changes lives — but so does awareness.
When communities learn that clefts are natural birth differences with well-established medical treatments, families are more likely to seek care early. Children are more likely to be accepted by their peers. Mothers are less likely to experience guilt or shame. Communities are less likely to believe myths or stereotypes.
Just as importantly, spreading awareness helps empower members of the cleft community to embrace their own stories and confidently share them with others.
Listen: Love Meets Joy
In this Smile Train-sponsored podcast, Iva Ballou and Ashley Barbour, two women with clefts, open up about their experiences with dating, relationships, bullying, portrayals of facial differences in pop culture, and everything in between.
Learn more: Ways to spread cleft awareness in your community
Where can families find support after a cleft diagnosis?
No family should have to navigate a cleft journey alone.
Cleft-affected families often report that finding emotional support and community has been as important to their healing as medical treatment.
This support can take many forms. Some families benefit from parent support groups shortly after diagnosis. Others find encouragement through community organizations, educational programs, online groups, conferences, or events that bring together cleft-affected people from around the world.
Smile Train supports a growing network of community programs in the US, UK, and in many of the countries where we support medical programs. No matter where they are, the goal is the same: helping cleft-affected families connect, learn, and advocate for greater awareness. These programs include:
- The Cleft Community Advisory Council, a group of cleft community members who help advance Smile Train’s communications strategies and advocate for the cleft community.
- Global Virtual Cleft Con, a once-a-year global gathering for everyone, everywhere affected by clefts.
- Cleft Con India, an in-person event just for India’s cleft community.
Each creates opportunities for cleft-affected individuals and families to build relationships, share experiences, and celebrate their achievements together.
These communities also play an important role in combating stigma. When families understand they are not alone — and when children grow up embraced by peers and mentors with similar experiences — they are better equipped to navigate challenges with confidence.
Dr. Mayuri Kalyanpad: From Patient to Doctor
Mayuri was a Smile Train patient, and just became a doctor herself! But it wasn’t until she spoke at Cleft Con India that the true impact of Smile Train’s model and community-building efforts became clear to her.
Learn more: Smile Train’s Cleft Community Programs
Key facts about cleft lips and cleft palates
The most important facts to remember are that a cleft is no one’s fault, effective treatment is available, and people with clefts can live full, healthy lives.
Science tells us that cleft lips and cleft palates are natural birth differences that develop early in pregnancy. In most cases, a person’s cleft has no single cause — and it is never anyone’s fault, certainly not the mother’s.
With comprehensive care that may include surgery, feeding support, speech therapy, dental care, ear and hearing care, and psychosocial support, people with clefts can live full, healthy, and fulfilling lives. A cleft need not prevent anyone from speaking clearly, succeeding in school, finding fulfilling work, starting a family, or achieving any other goal.
Just as important: Building community among cleft-affected people and raising public awareness of clefts helps replace harmful myths with facts so that families facing a cleft diagnosis are met with compassion instead of blame.
Every family deserves access to trusted information, quality care, and a community that understands what they’re experiencing. Together, they lay the foundation for giving every child with a cleft the opportunity to reach their fullest potential.
In review
Is a cleft lip or palate anyone’s fault?
No. Scientific evidence shows that clefts usually result from a complex combination of genetic and environmental factors. In most cases, there is no single identifiable cause, and parents should never blame themselves.
What causes cleft lips and cleft palates?
Researchers believe clefts develop early in pregnancy when the tissues that form the lip or palate do not join together completely. Genetics and certain environmental influences may play a role, but no single factor explains most cases.
Can people with clefts live healthy lives?
Yes. With timely, comprehensive care, people with clefts can live healthy, active lives and pursue their education, careers, relationships, and personal goals.
Can people with clefts speak clearly and effectively?
Many can. After cleft palate surgery, some children benefit from speech therapy, which helps them develop clear, effective communication.
Are clefts genetic?
Sometimes. Family history can increase the likelihood of a cleft, but many children with clefts have no known family history, and many families with a history of clefts never have another affected child.
Are clefts common?
About one in every 700 babies is born with a cleft, making them one of the most common birth differences globally.
What is comprehensive cleft care?
Comprehensive cleft care is team-based treatment that addresses every aspect of a person’s health and development. Depending on the individual, it may include surgery, feeding support, speech therapy, ear and hearing care, dental and orthodontic treatment, nutritional support, and psychosocial services.
Where can families find support after a cleft diagnosis?
Many hospitals have multidisciplinary cleft teams, and organizations such as Smile Train support community programs that connect families with trusted information and others who share similar experiences.