Cleft Palate

What Is A Cleft Palate?

Cleft palate is a congenital, or birth, defect that occurs when the roof of the mouth does not fuse completely during the first trimester of pregnancy.

A cleft palate might involve only the soft palate, which is in the back of the mouth closer to the throat, or the hard palate, which is in the front of the mouth closer to the teeth, or both.

Our internationally recognized team of surgeons and cross-disciplinary specialists work together to provide top-level quality care for your child while offering the utmost concern and support for your family.

Causes of Cleft Palate

If your child was born with a cleft palate, it is natural to wonder why.



Many cases of cleft palate are inherited, though a single gene has not been identified yet. Parents with clefting have a greater chance of having a child with clefting. Similarly, if one of their children already has the anomaly, there is a greater risk of having another child with the same birth defect.

It is normal to wonder if your child’s children will inherit clefting. Your child does have a higher chance at passing clefting on to his or her children.

Cleft palate can occur in any race, but some races, such as Native Americans and Asians, have a higher rate. 



Sixty percent of occurrences of cleft palates are not linked with anything that occurs during or after pregnancy. A few of the exceptions are:

  • Exposure to the drug phenytoin (Dilantin) during pregnancy.
  • Alcohol, anticonvulsants, and retinoic acid (vitamin A) are linked with other birth malformations that include cleft lip and palate.
  • Certain nutritional deficiencies in the mother, including folic acid deficiencies, are associated with birth defects.
More than 40 percent of cleft palates are part of malformation syndromes. That is, clefting is part of another syndrome caused by a genetic abnormality. The most common syndrome associated with cleft lip and palate together is van der Woude syndrome, while the most common syndrome linked to cleft palate is velocardiofacial syndrome.

Symptoms of Cleft Palate

Your child might have been diagnosed with cleft palate during a routine prenatal ultrasound. In most cases, cleft palate is diagnosed after birth based on a doctor’s examination of your baby. If the soft tissue is formed, cleft palate might not be diagnosed during the initial exam. Other symptoms, such as troubled feeding or breathing, can alert your pediatrician that your child might have clefting of the hard palate.

Characteristics of Cleft Palate:
  • A cleft palate can only be seen when the baby's mouth is open.
  • The cleft is a gap in the middle of the roof.
  • Your baby might have a difficult time feeding at first and might need to use a special bottle. A feeding specialist can help you choose the best bottle for your baby and will help you learn the best feeding technique for your baby. With the correct technique, your baby can learn to feed quite well. 
This list should be used as a guideline. Not every symptom is included. If your child has one or more of these symptoms, it does not mean that he or she has cleft palate. If you are concerned that your child might have cleft palate, please make an appointment with your child's doctor.

Because your child’s condition may be a symptom of a more complex syndrome, we use 3D CT imaging to provide a diagnosis more quickly and with more accuracy than ever before. Traditional CT scans provide black and white, one-dimensional scans, while advanced 3D imaging technology provides colored, multidimensional images that allow us to see the specific characteristics of your child’s condition. In this way, we can better understand how your child’s birth defect will specifically impact his or her health and development. 


Treatments for Cleft Palate

The treatment of cleft palate is more complex than the treatment for cleft lip. Children who have cleft palate can also have feeding difficulties, speech issues, earaches, hearing loss, and dental issues. 


Repair for cleft palate generally begins at 9 to 12 months old. Ear tubes, if needed, are placed at the same time as the palate surgery. In order to achieve the best aesthetic outcome and oral function, your child may need several surgeries.

During the planning stage of surgery, we use the most advanced 3D imaging techniques for a complete understanding of your child’s specific condition. By gathering accurate data, we can:
  • Simulate the outcome of proposed surgical plans and adjust any discrepancies before surgery
  • Follow and monitor your child’s condition during the post-surgical healing process
  • Monitor your child’s long-term development
Our team at the Yale Craniofacial Program will work closely with you to determine the best treatment plan for your child. Rest assured, your child will have among the best surgeons and specialists in the nation caring for him or her throughout the treatment process.

We will continue to follow your child’s speech, hearing, and dental development. Additional surgeries may be recommended in the future. Such procedures include pharyngeal flap, alveolar bone graft, rhinoplasty, and/or upper jaw surgery. With advanced, pre-surgical technology, such as nasoalveolar molding, your child may need fewer surgeries.