MFM Patient Education

Cleft Lip & Cleft Palate

Understanding your baby's prenatal diagnosis and what comes next

Prenatal Diagnosis Treatable Condition Multidisciplinary Care

Atlanta Perinatal Associates | DoctorsWhoCode.blog

What is it?

An Orofacial Cleft

A cleft forms when the lip or roof of the mouth does not fully close during early fetal development.

Cleft Lip (CL) Cleft Palate (CP) Both (CL/P)

Embryology diagram of facial development

Facial process fusion — weeks 4–12 of gestation

Prevalence

How Common Is It?

1 in 1,050

U.S. babies with cleft lip
with or without cleft palate

1 in 1,563

U.S. babies with cleft
palate alone

~70%

cases are isolated rather
than syndromic

Classification

Types of Clefts

Type	Description
Cleft Lip Only	Opening in the upper lip; palate intact
Cleft Palate Only	Opening in the roof of the mouth; lip intact
Cleft Lip & Palate	Both structures involved; most common combined form
Unilateral / Bilateral	Affects one or both sides of the face

3D ultrasound and postnatal photo of cleft lip

3D ultrasound (top) & postnatal appearance (bottom)

Prenatal Diagnosis

How Is It Diagnosed?

Modality	When	What It Shows
2D Ultrasound	18–22 weeks	Often shows cleft lip; isolated cleft palate is much harder to detect
3D/4D Ultrasound	Any trimester	Helps define surface anatomy and makes the finding easier for families to see
Fetal MRI	2nd–3rd trimester	Used selectively when the palate or associated anatomy is still unclear

Ultrasound Findings

What We See on Ultrasound

A cleft lip appears as a gap in the upper lip on 2D scan. 3D imaging provides a clearer surface view, helping parents understand the diagnosis.

"Fish-mouth" sign — 2D Surface view — 3D/4D

2D and 3D ultrasound images of fetal cleft lip

2D (top) and 3D (bottom) ultrasound of fetal cleft lip

Risk Factors

Why Does It Happen?

🧬 Genetics Family history or chromosomal variation

🌿 Environment Smoking, alcohol, and some antiseizure medicines can increase risk

🩺 Maternal Health Pre-pregnancy diabetes, low folate, and other early-pregnancy factors

❓ Unknown Many cases occur by chance with no identifiable cause

Genetic Considerations

Genetic Evaluation

Most clefts are isolated rather than syndromic, but some occur with chromosome differences or a broader genetic syndrome. A detailed anatomy scan and genetics counseling help decide whether additional testing is useful.

🔬 Chromosomal Microarray Recommended when other anomalies are present

📋 Detailed Anatomy Scan Evaluate for associated structural findings

🧑‍⚕️ Genetic Counseling Personalized risk assessment and family planning

Multidisciplinary Care

Your Care Team

👶 MFM Specialist

🏥 Plastic Surgery

🗣️ Speech Therapy

🦷 Orthodontics

Multidisciplinary cleft care team diagram

A coordinated team begins planning before delivery

Preparing for Birth

Feeding Your Baby

Cleft palate affects suction. Specialized bottles allow your baby to feed safely and effectively from day one.

Haberman Feeder SpecialNeeds Feeder

Our feeding specialists will train you before your due date.

Medela SpecialNeeds Feeder for cleft palate

Specialized feeder — enables effective feeding without suction

Treatment Journey

The Surgical Timeline

1

Birth

Feeding support & team
introduction

2

3–6 Months

Lip repair
if needed

3

9–18 Months

Palate repair
surgery

4

Childhood

Speech therapy,
orthodontics, follow-up

Your Role

What You Can Do Now

📅 Attend Follow-up Scans Detailed anatomy & growth monitoring

🧬 Genetic Counseling Understand your baby's specific diagnosis

🍼 Feeding Consultation Meet our feeding specialist before delivery

🤝 Meet the Cleft Team Prenatal consultation with plastic surgery

Our Commitment

You Are Not Alone

A cleft lip or palate is a treatable condition. With early diagnosis, expert surgical care, and a dedicated support team, your baby has every opportunity to thrive.

Treatable Expert Team Ready Excellent Outcomes

Questions? Ask your MFM specialist at your next visit.

Atlanta Perinatal Associates | DoctorsWhoCode.blog | OpenMFM.org