Cleft Lip and Palate

Cleft lip and cleft palate are openings or gaps in the upper lip or the roof of the mouth (palate). Cleft lip can occur in the middle of the lip or on one side (unilateral) or both sides (bilateral) of the lip. Cleft palate can occur in both the front (hard palate) and back (soft palate) parts of the palate, or it can occur in only one part of the palate.  

What causes Cleft Lip and Palate? 

When a baby is developing during pregnancy, body tissue and cells grow from each side of the head to meet in the middle of the face. When the tissues in the lip and/or palate do not join together before birth, it results in cleft lip and/or palate. The cause of this incomplete formation during pregnancy is not yet known.  

What are the symptoms of Cleft Lip and Palate? 

Cleft lip and palate can cause difficulty with a child’s feeding as a cleft can impact the ability to create a seal when nursing or bottle feedingA cleft palate also can allow more food to escape into the child’s nasal cavity.  

A cleft palate can impact a child’s speech in terms of articulation and resonance (e.g., speech sounds too nasal). Cleft lip alone does not typically impact speech. Cleft palate can impact control of the soft palate. The soft palate needs to be able to meet the back of the throat in order to produce sound that comes from our mouth. If the soft palate does not close all the way, air will come out of the nose as it does for sounds such as “m” and “n”. Articulation errors can also occur with cleft palate as the child may produce sounds in the wrong place, such as too far back in the mouth or in the throat. 

When is speech therapy recommended for Cleft Lip and Palate? 

Speech therapy can occur both before and after a surgical repair. Speech therapy is recommended for babies with cleft palate if the baby is having difficulty with feeding or is not producing many sounds and/or variation in sounds during babbling (e.g., only some vowels with little use of consonants) by 6 months of age. Speech therapy for toddlers and older children is recommended if the child is not speaking much or if they are not pronouncing sounds correctly.   

What does therapy for Cleft Lip and Palate involve? 

Speech therapy for cleft lip and palate involves teaching children the correct placement and manner for the production of errored sounds. Speech therapists will ensure that your child understands oral versus nasal airflow and teach your child how to produce good oral pressure. Speech therapy typically starts at the basic sound level, then focuses on learning to use the sound appropriately in words and sentences. Speech-language pathologists will help your child learn to hear if they are saying the sound right or wrong. Your therapist will also provide you with activities for you and your child to practice at home.   

Feeding therapy for cleft lip and palate ideally starts at birth. Speech-language pathologists can provide tips and specialized tools to help facilitate feeding.