Cleft upper lip means there is a gap or split in the baby’s upper lip that did not join together properly before birth. The split can look like a small notch or a wide opening, and it may go up toward the nose. It happens very early in pregnancy when the tissues of the face are forming and do not fuse completely.
A cleft upper lip (also called cleft lip) means the upper lip did not join fully while a baby was growing in the womb. It can look like a small notch or a wider gap that may reach the nose. It can happen on one side or both sides. Cleft lip can occur alone or with cleft palate (an opening in the roof of the mouth). The good news is that cleft lip is treatable, and most children do very well with the right care team and surgery plan. 1
Cleft upper lip is a type of orofacial cleft. It can happen alone or together with a cleft in the roof of the mouth, called a cleft palate. Babies with cleft upper lip may also have problems with feeding, ear infections, teeth, and speech if it is not treated by a special cleft team.
Doctors know that cleft upper lip is common all over the world. It appears in about 1 in 700 births when you include cleft lip with or without cleft palate. Most children can do very well after surgery and proper care from a team that includes surgeons, speech therapists, and dentists.
Other names
Cleft upper lip is usually called cleft lip in medical books and guidelines. The word “cleft” means a split or opening, and it describes the gap seen in the upper lip.
Sometimes older books use the word “harelip” because the lip can look like the lip of a hare or rabbit. Today, doctors avoid this word because many people find it hurtful and disrespectful. They prefer the kind and correct term “cleft lip” or “cleft upper lip.”
You may also see names like “unilateral cleft lip” when the split is on one side, or “bilateral cleft lip” when it is on both sides. When the cleft lip is present with a cleft palate, many sources write it as “cleft lip and palate.”
Types
Doctors describe types of cleft upper lip based on which side is affected and how large the gap is. This helps them plan the best surgery and follow-up care.
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Unilateral incomplete cleft upper lip – The split is on one side of the lip and does not reach all the way up into the nose. It may look like a notch or groove.
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Unilateral complete cleft upper lip – The split is on one side and goes all the way from the lip into the nostril. The nose on that side may look pulled or flattened.
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Bilateral complete cleft upper lip – There are two splits, one on each side of the upper lip, and both go into the nose. The middle part of the lip may look like it is hanging or pushed forward.
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Bilateral incomplete cleft upper lip – Both sides of the lip have a gap, but the splits do not fully reach the nose. The changes can be milder than in the complete form.
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Midline cleft upper lip – The split is in the center of the upper lip. This type is rare and is more often linked with other brain or facial problems.
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Microform cleft upper lip – This is a very mild type. It may look like a small dent, thin white line, or scar on the upper lip, but the underlying lip muscle can still be affected.
Causes
Doctors believe cleft upper lip has many causes working together, including genes and things in the environment. Often, no single cause is found for one baby, but research has shown several strong risk factors.
1. Genetic factors (family history)
If a parent, brother, sister, or close relative has a cleft lip or cleft palate, the risk is higher for the baby. This is because some genes that control facial growth can be passed down in families. Still, even with a family history, parents often do nothing wrong; it is just how the genes combine.
2. Specific genetic syndromes
Cleft upper lip can be part of a larger genetic syndrome, such as certain craniofacial or developmental syndromes. In these cases, the child may also have other features, like limb, heart, or brain differences. Genetic testing can help find the exact syndrome.
3. Chromosomal problems
Changes in the number or structure of chromosomes, such as deletions or duplications, can affect how the face forms in early pregnancy. These chromosomal changes may lead to cleft lip along with other birth differences.
4. Maternal smoking during pregnancy
Studies show that women who smoke during pregnancy have a higher chance of having a baby with cleft lip or palate. The chemicals in cigarette smoke may disturb blood flow and the delicate steps of facial fusion in the first weeks of pregnancy.
5. Maternal alcohol use
Heavy drinking in early pregnancy can harm the embryo’s facial development. Alcohol can interfere with cell growth and migration, which are needed for the lip parts to join, leading to clefts and sometimes other facial anomalies.
6. Certain medicines in early pregnancy
Some medicines taken in the first trimester (for example, some anti-seizure drugs, acne drugs with retinoic acid, or certain blood thinners) have been linked to a higher risk of cleft lip. Doctors try to use safer alternatives for women who are pregnant or planning pregnancy whenever possible.
7. Poor folic acid intake
Folic acid is a B-vitamin that helps cells divide and tissues close correctly. Low folic acid levels around conception are strongly linked to spinal defects and may also play a role in cleft lip risk. Prenatal vitamins with folic acid are usually recommended.
8. Maternal diabetes
Mothers who have diabetes before pregnancy, especially if blood sugar is not well controlled, have a higher chance of having a baby with birth defects, including cleft lip. High blood sugar can disturb normal growth signals in the embryo.
9. Maternal obesity
Being very overweight before pregnancy is another known risk factor. Excess body fat can change hormones and inflammatory signals, which may influence how the face and lip tissues form.
10. Maternal infections and high fever
Certain infections or high fever early in pregnancy may interfere with normal facial development. When the mother’s body is stressed by severe illness, the embryo can be more vulnerable to developmental errors.
11. Exposure to harmful chemicals
Contact with some industrial chemicals, pesticides, or heavy metals during early pregnancy has been studied as a possible risk. These substances may damage DNA or affect the way genes are turned on and off during facial development.
12. Radiation exposure
High doses of ionizing radiation in early pregnancy (for example, from major radiation accidents or repeated high-dose scans) can disturb organ formation. This can sometimes include orofacial clefts, although it is rare in usual medical care.
13. Very early pregnancy without prenatal care
Women who do not receive prenatal care may miss advice about vitamins, medicine safety, and lifestyle. Lack of this support can increase the chance that preventable risk factors, like smoking or poor nutrition, remain uncorrected in the first weeks.
14. Advanced maternal age
Babies born to older mothers have a slightly higher risk of some birth defects. Age can increase the chance of genetic or chromosomal errors, which may include those linked with cleft lip.
15. Consanguinity (parents closely related)
When parents are closely related (for example, cousins), they may share the same rare genes. If both pass such a gene to the baby, it can result in certain birth defects, including cleft lip, in some families.
16. Poor overall maternal nutrition
Not eating enough healthy food, proteins, vitamins, and minerals before and during early pregnancy may increase the risk of several congenital defects. The growing lip needs a steady supply of nutrients to form and fuse properly.
17. Maternal use of illegal drugs
Some illegal drugs can harm the developing embryo by reducing oxygen, changing blood flow, or directly damaging cells. This may raise the risk of orofacial clefts in addition to many other health problems.
18. Environmental tobacco smoke (second-hand smoke)
Even if the mother does not smoke, breathing in smoke from others can expose her and the baby to many of the same toxic chemicals. This can increase the risk of cleft lip slightly, as suggested by population studies.
19. Male sex of the baby (risk factor)
Cleft lip with or without cleft palate is more common in male babies than in females. Sex is not a “cause,” but it is a risk factor that shows there are biological differences in how boys and girls form their faces before birth.
20. Unknown or multifactorial causes
In many babies, no clear single cause can be found. Experts believe that most cases happen because several small genetic and environmental factors come together at a sensitive time in early pregnancy. This is called a multifactorial cause.
Symptoms
Cleft upper lip is usually seen right after birth, but some related problems appear later as the child grows. Not every child will have all the symptoms listed here, but these are common issues doctors and parents watch for.
1. Visible split in the upper lip
The main symptom is a visible gap, notch, or opening in the upper lip. It may be small or large and may be on one side, both sides, or in the middle. This is usually clear as soon as the baby is born.
2. Opening that extends into the nose
In complete cleft upper lip, the split reaches up into the nostril. The nose may look wider on one side, and the base of the nose can appear pulled or twisted.
3. Trouble latching onto breast or bottle
Because the lip cannot form a tight seal around the nipple, babies may have difficulty sucking. They may slip off the nipple or seem to tire quickly while feeding.
4. Milk leaking from the nose or mouth
When a cleft lip is present with a cleft palate, milk can escape into the nose during feeds. Even with only cleft lip, the flow of milk can be less well controlled, leading to dribbling and leaking.
5. Slow weight gain or poor growth
Feeding difficulties can mean the baby does not take in enough milk. Over time, this can cause slow weight gain or “failure to thrive” if feeding support is not given early.
6. Choking, coughing, or gagging while feeding
Some babies with cleft upper lip cough or choke more often when they drink, because they cannot control the flow of milk well. Special bottles and feeding positions can reduce this problem.
7. Frequent ear infections
If a cleft palate is also present, the tube that drains fluid from the middle ear may not work well. Fluid can build up and cause repeated ear infections, which may need ear tubes.
8. Hearing problems
Long-term fluid and infections in the middle ear can affect hearing. Mild to moderate hearing loss is common if ear problems are not treated early.
9. Nasal-sounding voice
Children with cleft lip and palate may have too much air escaping through the nose during speech. Their voice may sound very nasal, and some sounds are hard to make clearly.
10. Difficulty making certain speech sounds
Sounds that require good lip closure, such as “p,” “b,” and “m,” can be hard for children with a cleft upper lip, especially before repair. They may substitute other sounds, which can make speech hard to understand.
11. Dental problems near the cleft
Teeth near the cleft may be missing, extra, small, or twisted. The upper jaw may be narrow or misaligned, and the bite may not fit properly. Orthodontic treatment is often needed.
12. Changes in nose shape
The nostril on the cleft side may look collapsed, wide, or pulled up. The middle part of the nose may be off-center. These changes can affect both appearance and airflow.
13. Sinus and nasal problems
Because the normal structure of the nose and upper jaw is disturbed, some children have blocked noses or sinus infections more often. This can cause mouth breathing and snoring.
14. Social and emotional impact
Visible differences in the face can affect how a child feels about themselves and how others treat them. Some children may experience teasing or low self-esteem and may need emotional support or counseling.
15. Anxiety in parents and caregivers
The birth of a baby with cleft upper lip can cause strong emotions and worry in the family. They may feel guilty or fear the future. Support from the cleft team and parent groups is very important.
Diagnostic tests
Babies with cleft upper lip need careful evaluation by a full cleft and craniofacial team. This team often follows guidelines such as the Parameters of Care from the American Cleft Palate-Craniofacial Association (ACPA) and other national clinical practice guidelines.
Physical exam tests
1. Newborn general physical examination
Soon after birth, the doctor checks the baby from head to toe. They look at the face, mouth, heart, limbs, and organs to see if the cleft is isolated or part of a wider syndrome. This exam guides which extra tests are needed.
2. Detailed facial and lip examination
The doctor carefully inspects the upper lip, nose, and nearby skin to see the exact side, size, and type of cleft. They check whether it is complete or incomplete and whether one or both sides are involved. This helps plan the best surgical repair.
3. Oral cavity and palate examination
Using a light and sometimes a small tongue depressor, the doctor looks inside the mouth for a cleft palate, a split uvula, or other structural problems. Identifying a hidden or submucous cleft palate is important, because it strongly affects speech and feeding.
4. Growth and nutrition assessment
The baby’s weight, length, and head size are measured and compared against growth charts. Poor growth may show that feeding is not going well and that the child needs special feeding support or a nutrition plan.
Manual tests
5. Feeding observation and assessment
A nurse or feeding specialist watches the baby during breast or bottle feeding. They look at how the baby latches, how long they can feed, and whether they cough or choke. This helps decide if special bottles, nipples, or feeding positions are needed.
6. Suck–swallow–breathe coordination test
With a gloved finger or nipple in the baby’s mouth, the clinician gently feels how well the baby sucks and coordinates swallowing with breathing. Poor coordination can increase the risk of choking and may need tailored feeding strategies.
7. Speech and language evaluation
When the child is older, a speech-language pathologist listens to how the child produces sounds and words. They check for nasal speech, unclear sounds, or compensatory habits. This evaluation guides speech therapy and decisions about further surgery if needed.
8. Dental and bite (occlusion) examination
A pediatric dentist or orthodontist looks at the teeth and jaw relationship. They check for missing teeth, crowding, or incorrect bite. This manual exam helps decide when braces, plates, or other dental treatments are needed.
Laboratory and pathological tests
9. Routine pre-surgery blood tests (CBC, electrolytes)
Before cleft lip repair surgery, basic blood tests are done to check hemoglobin, white cells, platelets, and body salts. These tests help make sure the baby is healthy enough for anesthesia and surgery.
10. Coagulation profile (clotting tests)
Blood clotting tests such as PT and aPTT are often measured before surgery. Abnormal results may show a bleeding problem that must be corrected or watched closely during and after the operation.
11. Chromosomal karyotype or microarray
If the child has other birth differences or developmental delays, doctors may order chromosomal testing. This looks for extra or missing pieces of chromosomes that could explain a syndrome that includes cleft upper lip.
12. Targeted gene panel for cleft-related syndromes
Special gene tests can look for known genes linked with cleft lip and palate and certain craniofacial syndromes. Finding a clear gene cause can help with prognosis and family planning for future pregnancies.
Electrodiagnostic tests
13. Newborn hearing screening (OAE or ABR)
Most hospitals screen the baby’s hearing soon after birth. Tests like otoacoustic emissions (OAE) and auditory brainstem response (ABR) record tiny signals from the ear or hearing nerve. These tests are very important because ear fluid and infections are common in cleft conditions.
14. Detailed auditory brainstem response (ABR) test
If the screening shows a problem or if the child gets many ear infections, a more detailed ABR test may be done. It measures how sound signals travel along the hearing nerve to the brainstem and helps decide if hearing aids or ear tubes are needed.
15. Electrocardiogram (ECG) before anesthesia
Some centers record an ECG to check the heart rhythm before surgery, especially if the child has other medical issues. A normal ECG helps the anesthesiologist plan safe anesthesia and monitor the heart during the operation.
Imaging tests
16. Prenatal ultrasound
Cleft upper lip can often be seen on routine pregnancy ultrasound around 16–20 weeks, and in some centers even earlier. Seeing the cleft before birth gives parents time to meet the cleft team and plan delivery and early care.
17. Detailed fetal anomaly scan or 3D ultrasound
Special high-resolution or 3D ultrasound can show the face in more detail. It helps confirm the cleft, look for a cleft palate, and search for other structural differences in the heart, brain, or limbs.
18. Postnatal craniofacial CT scan
Later in childhood, a CT scan of the face and skull may be used to plan complex surgeries. It gives a three-dimensional picture of the bones, nasal passages, and upper jaw, which helps surgeons correct the shape and improve function.
19. Dental panoramic X-ray
A panoramic dental X-ray shows all the teeth and jaws in one picture. It helps the dentist see missing, extra, or poorly positioned teeth and plan timing of orthodontic treatment or bone grafts to the gum ridge.
20. Nasopharyngoscopy or videofluoroscopy for speech
In older children with speech problems, specialists may use a small camera through the nose (nasopharyngoscopy) or moving X-ray (videofluoroscopy) to watch how the soft palate and throat move during speech. This imaging helps decide if more surgery or a speech device is needed.
Non-pharmacological treatments (therapies and others)
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Cleft care team planning (multidisciplinary clinic)
This means your child is cared for by a group, not one doctor. The team often includes a plastic surgeon, pediatrician, speech therapist, dentist/orthodontist, and feeding specialist. The purpose is to plan the best timing for treatment and keep growth, feeding, speech, hearing, and teeth on track. The “mechanism” is teamwork: each expert solves a different part of the problem early. 3 -
Parent counseling and education
Parents learn what cleft lip is, what treatments usually happen, and what to expect after surgery. The purpose is to reduce fear and help parents make good choices. The mechanism is simple: clear education improves home care, feeding success, follow-up visits, and early problem spotting. 2 -
Feeding positioning (upright feeding)
Many babies with cleft lip (especially with cleft palate) swallow more air and may struggle to make suction. Feeding upright helps milk flow and can reduce choking and reflux. The purpose is safe feeding and steady weight gain. The mechanism is gravity and better airway control, so the baby can coordinate suck-swallow-breathe more safely. 6 -
Special bottles and nipples (cleft bottles)
Some bottles are designed to help deliver milk with less suction needed. The purpose is to help babies drink enough milk without getting tired. The mechanism is that the bottle system supports milk flow (sometimes by gentle squeezing or controlled valves), so the baby uses less effort. 7 -
Burping techniques (more frequent burps)
Babies with cleft conditions often take in extra air while feeding. The purpose of frequent burping is to reduce discomfort, vomiting, and feeding refusal. The mechanism is removing trapped air from the stomach before it causes pain or spit-ups, which helps the baby finish feeds. 6 -
Weight and growth monitoring
Regular weight checks make sure the baby is gaining well before surgery. The purpose is safety because good nutrition supports healing and lowers surgical risk. The mechanism is early detection: if growth slows, the team adjusts feeding methods or calories quickly. 3 -
Pre-surgical lip taping
Lip taping gently brings the cleft segments closer over time. The purpose is to reduce the cleft gap and improve lip shape before surgery. The mechanism is steady, mild tension on skin and soft tissue that guides the lip segments toward a better position. 4 -
Nasoalveolar molding (NAM)
NAM is a device used in some babies before surgery to shape the gums and nose. The purpose is to improve nose symmetry and reduce the cleft width before the main repair. The mechanism is slow molding: gentle pressure guides cartilage and gum segments while tissues are flexible in early infancy. 4 -
Regular cleaning of the mouth and lip area (gentle hygiene)
Keeping the area clean reduces irritation and infection risk. The purpose is comfort and fewer infections, especially before and after surgery. The mechanism is removing milk residue and bacteria so the skin and gums stay healthier and heal better. 2 -
Speech and language screening (early checks)
Cleft lip alone may not cause big speech issues, but screening is important—especially if cleft palate is present. The purpose is to detect speech delay early. The mechanism is early therapy: small problems are easier to fix when addressed early, before habits become strong. 2 -
Speech therapy (if needed)
If speech is nasal or unclear (often with cleft palate), a speech therapist teaches correct sound patterns. The purpose is clearer communication and confidence. The mechanism is training the mouth and airflow patterns through exercises and guided practice over time. 2 -
Hearing checks (audiology follow-up)
Children with cleft palate often have middle ear fluid and ear infections, which can affect hearing. The purpose is to protect hearing and language development. The mechanism is testing and early treatment (like ear tubes if needed) so sound reaches the inner ear clearly. 2 -
Dental and gum care education
Cleft conditions can affect tooth position and gum shape. The purpose is to prevent cavities and protect developing teeth. The mechanism is regular brushing guidance, early dental visits, and preventive care so teeth stay healthy for later orthodontic steps. 3 -
Orthodontic evaluation (when age-appropriate)
Some children need braces or other devices later to guide teeth and jaw growth. The purpose is better bite, chewing, and appearance. The mechanism is slow tooth movement and growth guidance using gentle forces applied over months to years. 3 -
Psychological support for child and family
A visible lip difference can affect feelings and confidence, and parents may feel stress or guilt. The purpose is emotional health and resilience. The mechanism is counseling and coping skills that reduce anxiety, improve bonding, and support social confidence. 3 -
School support and anti-bullying plan
Some children face teasing due to appearance or speech. The purpose is safety and self-esteem. The mechanism is early communication with teachers and clear rules so the child is protected, supported, and included. 3 -
Sleep and breathing check (airway assessment)
If the cleft condition is part of a syndrome or if there are breathing issues, airway checks matter. The purpose is to prevent sleep breathing problems and feeding-breathing stress. The mechanism is screening (history, exam, sometimes sleep study) to identify problems that need treatment. 4 -
Genetic counseling (when recommended)
Sometimes cleft lip happens alone, and sometimes it is part of a genetic condition. The purpose is to understand risk in future pregnancies and check for related health issues. The mechanism is family history review and, when needed, genetic testing guided by specialists. 1 -
Good nutrition plan (protein and calories)
Good nutrition supports growth and healing. The purpose is to reach surgery safely and recover well. The mechanism is providing enough calories plus protein, vitamins, and minerals so the body can build tissue and fight infection. 10 -
Follow-up schedule (long-term care)
Cleft care is not “one visit.” The purpose is to track growth, speech, teeth, scars, and emotional health. The mechanism is timed checkups across childhood so problems are found early and treated at the best time. 3
Drug treatments (supportive medicines used around cleft lip care)
Important note: Cleft lip is mainly corrected by surgery and team care, not long-term medicines. These drugs are usually used for surgery, pain control, infection prevention, nausea control, and safe anesthesia, and dosing must be decided by licensed clinicians (especially for babies and children). 3
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Acetaminophen (pain and fever control)
Used to reduce pain after cleft lip repair and help the child rest and feed. Purpose: safe baseline pain control. Mechanism: lowers pain signaling and reduces fever in the brain. Typical use: scheduled for 24–72 hours after surgery (doctor decides exact dose). Side effects can include liver injury if overdosed. 11 -
Ibuprofen (pain and swelling control)
Often used after surgery to reduce pain and inflammation. Purpose: lessen swelling and improve comfort. Mechanism: blocks COX enzymes, lowering prostaglandins that cause pain and swelling. Timing: sometimes started after surgery if the surgeon approves. Side effects can include stomach irritation or bleeding risk in some patients. 12 -
Ketorolac (short-term stronger NSAID for pain)
Used for short periods for moderate to severe post-operative pain (often in hospital). Purpose: reduce need for opioids. Mechanism: strong COX inhibition reduces pain mediators. Timing: short-term only, based on surgeon/anesthesia plan. Side effects can include bleeding risk, kidney stress, or stomach irritation. 13 -
Amoxicillin-clavulanate (infection treatment/prophylaxis when needed)
Sometimes used if there is concern for infection risk or if an infection develops (doctor choice). Purpose: treat bacteria that can infect skin or mouth areas. Mechanism: amoxicillin kills bacteria; clavulanate helps block resistance enzymes. Timing: short course if prescribed. Side effects may include diarrhea or allergy reactions. 14 -
Amoxicillin (infection treatment when needed)
Used for certain bacterial infections that may occur in infancy/childhood, including some ear or respiratory infections (common in cleft palate care). Purpose: clear susceptible bacteria. Mechanism: blocks bacterial cell wall building. Timing: prescribed course only. Side effects may include rash, diarrhea, or allergy. 15 -
Cefazolin (peri-operative antibiotic in the hospital)
Often used as a single dose (or short series) around surgery to lower infection risk. Purpose: prevent surgical site infection. Mechanism: cephalosporin antibiotic that disrupts bacterial cell wall formation. Timing: usually given right before incision by the surgical team. Side effects can include allergy reactions. 16 -
Clindamycin (alternative antibiotic for certain allergies)
Used if a patient cannot take beta-lactam antibiotics (doctor decision). Purpose: treat or prevent infection with certain bacteria. Mechanism: blocks bacterial protein production. Timing: short course or peri-operative use. Side effects can include diarrhea; rarely, severe colon inflammation can occur. 17 -
Cephalexin (oral antibiotic option in select cases)
Sometimes used after surgery if the surgeon prescribes it or for skin infections. Purpose: treat susceptible bacteria. Mechanism: blocks bacterial cell wall building. Timing: limited course. Side effects can include stomach upset or allergy in some people. 18 -
Lidocaine (local anesthetic)
Used by clinicians to numb tissues during procedures or for local pain control. Purpose: reduce pain signals at the site. Mechanism: blocks sodium channels in nerves so pain signals cannot travel. Timing: used during procedures under medical supervision. Side effects can occur if too much is absorbed, so clinicians calculate safe amounts. 19 -
Bupivacaine (longer-acting local anesthetic)
Often used to provide longer numbness after surgery, helping early pain control. Purpose: extended comfort and less need for stronger medicines. Mechanism: nerve sodium channel block with longer duration than lidocaine. Timing: placed by surgeon/anesthesia team during surgery. Side effects can be serious if overdosed, so it is strictly clinician-managed. 20 -
Epinephrine (often combined with local anesthetic)
Used in small controlled amounts to reduce bleeding and prolong local anesthetic effect. Purpose: better surgical visibility and longer numbness. Mechanism: tightens blood vessels (vasoconstriction) in the area. Timing: used during surgery by trained teams. Side effects can include fast heartbeat if absorbed systemically. 21 -
Ondansetron (nausea and vomiting prevention)
Commonly used around anesthesia to prevent vomiting, which can stress surgical repairs and cause dehydration. Purpose: reduce nausea. Mechanism: blocks serotonin (5-HT3) signaling linked to vomiting. Timing: often given during or after surgery. Side effects can include headache or constipation in some people. 22 -
Dexamethasone (swelling and nausea support in surgery)
Used by anesthesia teams to reduce post-operative swelling and nausea in many surgeries. Purpose: smoother recovery. Mechanism: corticosteroid that reduces inflammatory signals. Timing: often a single peri-operative dose. Side effects depend on dose and duration; a single surgical dose is commonly well tolerated under supervision. 23 -
Midazolam (pre-procedure calming, hospital use)
Sometimes used before anesthesia to reduce fear and help with smooth induction (mainly in hospital). Purpose: reduce anxiety and improve cooperation. Mechanism: enhances GABA activity in the brain, causing sedation. Timing: short-term, clinician-controlled. Side effects can include sleepiness and slowed breathing, so monitoring is required. 24 -
Propofol (anesthesia medicine, hospital use only)
Used to start or maintain anesthesia during surgery. Purpose: unconsciousness and comfort during the procedure. Mechanism: strengthens inhibitory brain signaling (GABA-related effects), causing sedation/anesthesia. Timing: only given by anesthesia professionals with full monitoring. Side effects can include low blood pressure or breathing suppression, so it requires trained care. 25 -
Sevoflurane (inhaled anesthesia, hospital use only)
Often used to keep a patient asleep during surgery, especially in children. Purpose: controlled anesthesia. Mechanism: inhaled anesthetic that affects brain signaling to keep the patient unconscious. Timing: used in the operating room with monitoring. Side effects can include nausea, low blood pressure, or agitation during wake-up in some cases. 26 -
Fentanyl (strong pain medicine, hospital use only)
Used by anesthesia teams for short-term pain control during or right after surgery. Purpose: manage strong surgical pain. Mechanism: opioid receptor activation reduces pain perception. Timing: given only under close monitoring. Side effects can include slowed breathing, so it is carefully controlled and not a home medicine. 27 -
Morphine (strong pain medicine, hospital use only)
Used for significant pain in a monitored setting. Purpose: treat severe pain when needed. Mechanism: opioid receptor activation reduces pain signals and pain response. Timing: typically in hospital, individualized by clinicians. Side effects can include sleepiness and slowed breathing, so monitoring is required. 28 -
Oxycodone (strong pain medicine, limited use if prescribed)
Sometimes prescribed for short-term severe pain after surgery (depending on clinician and local practice). Purpose: help when other medicines are not enough. Mechanism: opioid receptor activation reduces pain. Timing: shortest time possible at the lowest effective amount, only if prescribed. Side effects include constipation and breathing risk, so careful supervision is essential. 29 -
Naloxone (opioid reversal, emergency medicine)
This medicine reverses opioid effects if dangerous breathing suppression happens. Purpose: safety backup when opioids are used. Mechanism: blocks opioid receptors and can rapidly restore breathing. Timing: used in emergencies by trained people; families may be educated if opioids are prescribed. Side effects can include sudden withdrawal symptoms in opioid-exposed patients. 30
Dietary molecular supplements
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Vitamin C
Vitamin C helps the body make collagen, which is a key building block for skin and wound healing. Purpose: support tissue repair after surgery and support immune function. Mechanism: acts as a cofactor for collagen formation and as an antioxidant. Typical dosing depends on age and diet; high doses can upset the stomach. 8 -
Zinc
Zinc supports immune function and is important for normal wound healing. Purpose: support healing and reduce deficiency risk. Mechanism: zinc is needed for many enzymes involved in tissue repair and immune response. Dose should be age-appropriate; too much can cause nausea and can reduce copper absorption over time. 9 -
Vitamin A
Vitamin A supports skin and immune defenses. Purpose: help normal tissue repair and immune protection when intake is low. Mechanism: supports cell growth and immune function. Too much vitamin A can be harmful, especially in pregnancy, so supplementation should be cautious and clinician-guided. 31 -
Vitamin D
Vitamin D supports bone and immune function. Purpose: support overall health and recovery if levels are low. Mechanism: helps regulate calcium balance and immune signaling. Overuse can cause high calcium, so supplementation should be based on medical advice or testing when possible. 32 -
Iron
Iron is needed to make hemoglobin, which carries oxygen to healing tissues. Purpose: prevent or correct anemia that can slow recovery. Mechanism: improves oxygen delivery for energy and repair. Too much iron can be harmful, so supplement only if a clinician recommends it. 33 -
Folate (vitamin B9)
Folate supports normal cell growth and blood formation. Purpose: support healthy growth and recovery, especially if dietary intake is low. Mechanism: needed for DNA formation and cell division. Excess folate can hide vitamin B12 deficiency, so balanced care matters. 35 -
Vitamin B12
Vitamin B12 supports nerve function and blood cell formation. Purpose: reduce risk of anemia or nerve problems if diet is low in animal foods or absorption is poor. Mechanism: helps make red blood cells and supports nerve tissue. Dose should match age needs and medical advice. 36 -
Omega-3 fatty acids (EPA/DHA)
Omega-3s support heart and brain health and can affect inflammation. Purpose: general nutrition support, especially if fish intake is low. Mechanism: omega-3s are part of cell membranes and influence inflammation signaling. High doses can increase bleeding risk in some settings, so discuss before surgery. 34 -
Probiotics (only with clinician approval in infants/weak immunity)
Probiotics are live microorganisms used to support gut balance. Purpose: help gut health in some people, especially after antibiotics. Mechanism: may support healthy gut bacteria and immune signaling. Safety matters: rare serious infections have been reported in vulnerable infants, so clinician guidance is important. 37 -
Arginine (amino acid nutrition support in selected cases)
Arginine is an amino acid sometimes studied for wound healing support. Purpose: support collagen formation and immune response in people with poor nutrition. Mechanism: helps nitric oxide pathways and may support collagen and tissue repair processes. It is not routine for cleft lip, and it should be used only with medical guidance. 38
Immunity booster / regenerative / stem-cell options
Key truth: There is no FDA-approved “stem-cell drug” that fixes cleft lip. Cleft lip repair is done with surgery and team care. Some immune or regenerative therapies exist for other medical conditions, but they are not routine for cleft lip and should not be used without specialist diagnosis. 3
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Palivizumab (RSV prevention in certain high-risk infants)
This is an antibody shot used to help prevent severe RSV infection in specific high-risk babies. Purpose: reduce severe RSV disease risk (not “fix” cleft). Mechanism: binds RSV and helps block infection in the body. Timing: monthly during RSV season for eligible infants, decided by pediatric specialists. Side effects can include injection site reactions. 40 -
Filgrastim (stimulates neutrophils in severe neutropenia)
This drug boosts neutrophil production in people with serious low white blood cells (usually from chemo or specific conditions). Purpose: lower infection risk when neutrophils are dangerously low. Mechanism: a growth factor that stimulates bone marrow to make neutrophils. Not a cleft treatment; only used when a doctor diagnoses neutropenia. 41 -
Pegfilgrastim (long-acting neutrophil growth factor)
Similar purpose to filgrastim but lasts longer. Purpose: reduce infection risk in certain patients with predicted severe neutropenia. Mechanism: long-acting G-CSF stimulation of neutrophil production. It is not related to cleft repair and is used only for specific medical indications under specialists. 42 -
Sargramostim (GM-CSF; immune cell growth factor)
This medicine can support recovery of white blood cells in special medical settings. Purpose: help immune cell recovery when medically necessary. Mechanism: stimulates bone marrow to produce certain white blood cells. It does not treat cleft lip; it is used only for specific serious indications with careful monitoring. 43 -
Becaplermin gel (a growth-factor “regenerative” wound medicine for specific ulcers)
This is a topical growth-factor gel approved for certain diabetic foot ulcers, not for cleft lip wounds. Purpose: support healing in specific chronic ulcers under medical supervision. Mechanism: platelet-derived growth factor activity that supports wound repair steps. It is not routine for facial surgery wounds and should not be self-used. 44 -
Hematopoietic progenitor cells (cord blood) — stem-cell product for transplant (not for cleft lip)
Cord-blood stem cell products are used in certain blood and immune system disorders needing transplantation. Purpose: rebuild blood/immune function in serious diseases. Mechanism: stem cells repopulate bone marrow after conditioning therapy. This is not a cleft lip therapy and is only used in transplant centers for specific diseases. 45
Surgeries (procedures and why they are done)
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Primary cleft lip repair (cheiloplasty)
This is the main surgery to close the lip gap and shape the lip muscles and skin. It is done to improve feeding, appearance, and normal lip function. The “why” is to restore muscle continuity so the lip can move more normally and look more balanced. 2 -
Primary nasal repair (nose shaping during lip repair)
Some surgeons adjust the nose at the same time as lip repair. It is done to improve nostril shape and nose symmetry. The “why” is that the cleft often pulls the nose cartilage out of position, and early correction can improve balance as the child grows. 4 -
Revision lip surgery (secondary lip revision)
Some children need a small later procedure to improve the lip scar, symmetry, or muscle function. It is done when growth reveals small imbalances. The “why” is to fine-tune function and appearance after the first repair has healed and the child has grown. 3 -
Cleft rhinoplasty (later nose surgery, if needed)
A more complete nose reshaping may be done later in childhood or teenage years. It is done to improve breathing through the nose and improve symmetry. The “why” is that nose growth continues for years, so final shaping is often best when growth is more complete. 3 -
Alveolar bone graft (if the cleft affects the gum line/alveolus)
If the cleft extends into the upper gum area, bone grafting may be needed later to support teeth and jaw stability. It is done to help permanent teeth erupt and to stabilize the dental arch. The “why” is to rebuild missing bone so teeth and orthodontics can work better. 3
Preventions (what can reduce risk)
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Avoid smoking and second-hand smoke during pregnancy
Smoking is linked to many pregnancy risks, and avoiding it supports healthier fetal development. The purpose is risk reduction for birth defects and better pregnancy health. The mechanism is fewer toxic exposures that can affect fetal growth and tissue formation. 1 -
Avoid alcohol during pregnancy
Alcohol can affect fetal development, and avoiding it is a common public health recommendation. The purpose is safer fetal growth. The mechanism is preventing alcohol-related disruption of normal tissue development. 1 -
Take prenatal folic acid as advised
Folate supports normal early development. The purpose is to support healthy fetal growth. The mechanism is supporting DNA formation and cell division during early pregnancy. Always follow prenatal advice from a clinician. 35 -
Manage diabetes before and during pregnancy (medical care)
Good diabetes control supports healthier pregnancy outcomes. Purpose: reduce complications linked with high blood sugar. Mechanism: stable blood sugar supports normal fetal development and reduces stress on development pathways. 1 -
Review medicines with a clinician before pregnancy
Some medicines may affect pregnancy, so planning helps. Purpose: safer medication choices. Mechanism: replacing or adjusting risky medicines reduces exposures that could affect fetal development. 1 -
Treat nutrition deficiencies before pregnancy
Correcting low iron, low vitamin D, or other deficiencies supports healthy pregnancy. Purpose: stronger maternal health and fetal support. Mechanism: better oxygen carrying capacity and healthier immune and bone metabolism during pregnancy. 33 -
Maintain a balanced diet in pregnancy
A balanced diet supports normal fetal growth. Purpose: provide building blocks for development. Mechanism: steady supply of protein, vitamins, and minerals supports tissue formation and growth. 10 -
Attend regular prenatal care visits
Prenatal visits help identify risks early and provide guidance. Purpose: early detection and prevention. Mechanism: screening and support (like nutrition counseling and managing chronic disease) improves pregnancy outcomes. 1 -
Genetic counseling if there is family history
If cleft conditions run in the family, counseling can clarify recurrence risk. Purpose: informed planning. Mechanism: family history review and targeted testing can identify syndromic risks and guide prenatal decisions. 1 -
Avoid harmful chemical exposures when possible
Reducing exposure to strong toxins at work or home is a general pregnancy safety step. Purpose: safer fetal environment. Mechanism: fewer harmful exposures reduces stress on early tissue development. 1
When to see doctors
See a doctor as soon as possible if a baby is born with a cleft upper lip, so feeding and growth can be supported early and a cleft team can plan surgery. Also see a doctor urgently if the baby has poor feeding, choking, poor weight gain, repeated vomiting, breathing trouble, fever, or signs of dehydration. After surgery, urgent review is needed for bleeding, spreading redness, bad smell/pus, fever, or the wound opening. Early care improves safety and results. 2
What to eat and what to avoid
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Eat: enough protein (eggs, fish, chicken, lentils, milk/yogurt)
Protein helps the body rebuild tissue after surgery. Purpose: better healing. Mechanism: provides amino acids needed for collagen and new tissue formation. 10 -
Eat: vitamin-C foods (guava, citrus, tomatoes, peppers)
These foods support collagen building and healing. Purpose: support wound repair. Mechanism: vitamin C helps collagen formation and acts as an antioxidant. 8 -
Eat: zinc foods (meat, beans, nuts, seeds)
Zinc supports immunity and healing. Purpose: lower deficiency risk. Mechanism: zinc supports enzymes and immune cell functions needed for repair. 9 -
Eat: iron foods (meat, lentils, spinach) if advised
Iron supports oxygen delivery. Purpose: reduce anemia risk. Mechanism: hemoglobin carries oxygen to healing tissues. 33 -
Eat: fruits and vegetables daily
They provide fiber and many vitamins/minerals. Purpose: overall recovery support. Mechanism: nutrients support immune function and energy metabolism while fiber supports gut health. 10 -
Eat: enough fluids (water, soups, milk as suitable)
Hydration supports circulation and recovery. Purpose: prevent dehydration (especially important after surgery). Mechanism: fluids support blood flow, temperature control, and digestion. 10 -
Avoid: very hard or sharp foods right after lip surgery (if surgeon says so)
Hard foods can stress stitches. Purpose: protect the repair. Mechanism: less mechanical force on the healing lip lowers risk of wound opening. 2 -
Avoid: very spicy or very acidic foods if they irritate the wound
Irritation can reduce comfort and feeding. Purpose: easier eating and better intake. Mechanism: less burning/irritation helps the child feed and heal. 2 -
Avoid: sugary drinks and frequent sweets
Sugar increases cavity risk, and dental care is important in cleft conditions. Purpose: protect teeth. Mechanism: less sugar means less acid-producing bacteria on teeth. 3 -
Avoid: non-prescribed supplements right before surgery
Some supplements can affect bleeding or interact with medicines. Purpose: surgical safety. Mechanism: avoiding unknown effects reduces bleeding and anesthesia risks. Always tell the surgical team what you take. 10
FAQs
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Is cleft upper lip the same as cleft palate?
No. Cleft lip is an opening in the upper lip. Cleft palate is an opening in the roof of the mouth. Some children have both. 1 -
Is cleft lip life-threatening?
Usually no, but feeding problems can cause poor weight gain if not treated early. Early medical support makes it much safer. 2 -
Can cleft lip be cured?
It can be repaired very effectively with surgery, and most children have good function and appearance afterward. 2 -
What causes cleft lip?
Often there is no single cause. It can be linked to genes and environmental factors during pregnancy. 1 -
Did the parents do something wrong?
Most of the time, no. Many cases happen without a clear reason, and blame is not helpful. Focus on treatment and support. 1 -
Can a baby with cleft lip breastfeed?
Some can breastfeed, but others need special techniques or bottles—especially if cleft palate is present. A feeding specialist can help. 6 -
Why are special bottles sometimes needed?
They help milk flow with less suction, so the baby can feed safely and gain weight. 7 -
When is cleft lip surgery usually done?
Timing depends on the child’s health, weight, and the surgeon’s plan, but it is commonly done in early infancy. Your cleft team will guide timing. 2 -
Will my child need more than one surgery?
Some children do, especially if there are nose, gum, or palate issues, or if revisions are needed as they grow. 3 -
Will my child have a scar?
Yes, but surgeons place incisions carefully, and scars often fade with time. Some children may later choose revision for the best appearance. 2 -
Does cleft lip affect speech?
Cleft lip alone may have mild effects, but cleft palate can affect speech more strongly. Screening and speech therapy help a lot. 2 -
Does cleft lip affect hearing?
Hearing problems are more common when cleft palate is present, due to ear fluid. Regular hearing checks are important. 2 -
Are medicines a main treatment for cleft lip?
No. Medicines are usually supportive (pain control, anesthesia, infection prevention). Surgery and team care are the main treatments. 3 -
Are “stem cell drugs” available to repair cleft lip?
No FDA-approved stem-cell drug repairs cleft lip. Stem-cell products exist for transplant in specific diseases, but not for cleft lip repair. 45 -
What is the most important thing families can do early?
Get connected with a cleft team early, focus on safe feeding and growth, and keep regular follow-ups. Early support improves outcomes. 3
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: January 30, 2025.
