Labium Leporinum

Labium leporinum is a Latin medical name for “harelip,” which means a cleft lip. A cleft lip is a birth problem where there is a gap or split in the upper lip because the lip did not join together properly while the baby was growing inside the mother’s womb. The opening can be small, like a notch, or very big and go all the way up into the nose. [1]

Labium leporinum means cleft lip. It is a birth condition where the upper lip does not join fully while a baby is growing in the womb. The split can be small (like a tiny notch) or large (it can reach the nose). It can be on one side or both sides. Cleft lip may happen alone, or with cleft palate (a split in the roof of the mouth). A care team usually includes a plastic surgeon, feeding specialist, dentist/orthodontist, speech specialist, and ear–nose–throat doctor.

Doctors explain that the upper lip normally forms during the first 6–8 weeks of pregnancy. Different pieces of tissue in the baby’s face grow towards each other and fuse (join). In labium leporinum, some of these pieces do not meet fully, so a gap stays in the lip. This is why we call it a “congenital” problem, which means the baby is born with it and did not get it later. [2]

In everyday language, people often use the term “cleft lip” instead of “harelip,” because “harelip” can sound rude or hurtful. Big health systems such as Mayo Clinic and Cleveland Clinic now prefer the words “cleft lip” and “cleft palate.” These names describe the condition clearly and respectfully. [3]

When a cleft lip happens together with a cleft in the roof of the mouth (cleft palate), breathing, feeding, speaking, teeth, and ear health can all be affected. Children usually need care from a special team, including surgeons, dentists, speech therapists, ear specialists, and psychologists, to help them grow and live a healthy life. [4]

Other names of labium leporinum

The Latin term “labium leporinum” literally means “hare’s lip.” In medical books, it is listed as one of the formal synonyms for cleft lip. [1]

Other names and related terms include:

• Cleft lip – the most common, modern and respectful term. [2]

• Harelip – an older everyday term that many people now consider offensive, so doctors try not to use it. [3]

• Cheiloschisis – a Greek-based medical word that also means cleft lip. [4]

• Congenital fissure of the lip – an older descriptive phrase used in some books. [5]

All these names point to the same main idea: a split in the upper lip that is present at birth because the tissues did not fuse completely during early pregnancy. [6]

Types of labium leporinum

Doctors divide labium leporinum (cleft lip) into several types. This helps them describe the problem clearly and plan the right surgery and care. [1]

1. Unilateral cleft lip
   This means the cleft is on one side of the upper lip only, either the left or the right. It can be small or large. Unilateral clefts are more common than clefts in the middle. [2]

2. Bilateral cleft lip
   Here, there is a split on both sides of the upper lip. The middle part of the lip and gum can look like a small island of tissue. This type is usually more complex and may need more than one surgery. [3]

3. Incomplete cleft lip
   In this type, the split does not go all the way into the nose. It may look like a deep notch or indentation in the lip. Muscles under the lip can still be separated, so surgery is usually helpful. [4]

4. Complete cleft lip
   The opening goes from the lip up into the nostril. The lip, gum, and base of the nose can all be involved. This type often changes the shape of the nose and may also affect teeth and jaw growth. [5]

5. Microform cleft lip (“forme fruste”)
   This is a very mild type. It may look like a small dent, fine line, or scar on the lip, but the deeper muscles can still be abnormal. Even this mild form can sometimes affect symmetry and may be treated by a specialist team. [6]

6. Cleft lip with cleft palate
   In many babies, the cleft lip occurs together with a cleft in the roof of the mouth. This combination is often called “cleft lip and palate” or “orofacial cleft.” It has more effects on feeding, speech, and ears than cleft lip alone. [7]

7. Isolated cleft lip (without cleft palate)
   In some babies, only the lip is affected and the palate is closed. These children still need careful care for teeth, speech, and appearance, but feeding may be a bit easier than when the palate is also open. [8]

8. Syndromic cleft lip
   Sometimes the cleft lip is part of a larger syndrome, which means the child has other features or health problems due to a shared genetic cause. In these cases, doctors also look for heart, limb, or brain differences, depending on the syndrome. [9]

9. Nonsyndromic cleft lip
   Here, the child has a cleft lip but no other clear syndrome or multiple anomalies. Even in nonsyndromic cases, genetic and environmental factors still play a role. [10]

Causes (risk factors) of labium leporinum

Most experts agree that there is no single cause for most cleft lips. The cause is usually “multifactorial,” which means many genes and many environmental factors work together. [1]

1. Family history and genes
   If a close relative has a cleft lip or palate, the chance is higher that a baby in the family may be born with labium leporinum. This is because some genes that control face development can run in families. [2]

2. Specific genetic changes or syndromes
   Certain gene changes and chromosomal conditions (for example, some forms of syndromic cleft lip) can directly lead to a cleft. In these cases, the cleft lip is one part of a wider pattern of birth differences. [3]

3. Maternal smoking during early pregnancy
   Smoking in early pregnancy reduces oxygen and exposes the baby to chemicals. Studies show that smoking raises the risk of orofacial clefts in the baby. [4]

4. Alcohol use in pregnancy
   Heavy drinking in pregnancy can disrupt normal face and brain development. Cleft lip can be one of several problems seen in babies whose mothers drank large amounts of alcohol during early pregnancy. [5]

5. Poor folic acid intake or nutritional deficiency
   Low levels of folic acid and possibly other vitamins in the mother’s diet may increase the risk of clefts. Good nutrition before and during early pregnancy helps the baby’s face form correctly. [6]

6. Maternal diabetes
   Women with poorly controlled diabetes before or early in pregnancy have a higher chance of having a baby with birth defects, including cleft lip and palate. Good blood sugar control may reduce this risk. [7]

7. Maternal obesity
   Being significantly overweight before pregnancy is linked with a higher risk of some birth defects, including orofacial clefts, possibly through hormone and metabolic changes. [8]

8. Certain medicines in early pregnancy
   Some medicines, such as certain anti-seizure drugs and very strong acne medicines (like retinoids), have been linked to clefts when taken in the first weeks of pregnancy. Doctors try to avoid these drugs or adjust them in women who may become pregnant. [9]

9. Exposure to toxins or chemicals
   Contact with some industrial chemicals, pesticides, or solvents in early pregnancy may raise the risk, especially when combined with genetic susceptibility. [10]

10. Maternal infections
    Some infections in the mother during early pregnancy may disturb the development of the baby’s face and lip. Vaccination and infection control help lower this risk. [11]

11. Lack of oxygen or high altitude (hypoxia)
    Research suggests that low oxygen levels early in pregnancy can affect the way the palate and lip fuse. This may happen in mothers with severe lung disease or in certain environmental conditions. [12]

12. Advanced maternal age
    Older maternal age is linked with a higher risk of some birth defects, including clefts, likely because of changes in eggs and increased chance of gene errors. [13]

13. Ethnic and geographic background
    Cleft lip and palate are more common in some populations (for example, some Asian and Native American groups) and less common in others, which shows the importance of genetic background and local factors. [14]

14. Consanguinity (parents being closely related)
    When parents are closely related (for example, cousins), there is a higher chance that both carry the same harmful gene, which can increase the risk of clefts in the baby. [15]

15. Maternal stress and hormone changes
    Severe long-term stress early in pregnancy might affect blood flow and hormone levels, and has been discussed as a possible contributor, although evidence is weaker than for smoking or genes. [16]

16. Uncontrolled seizure disorders and their treatment
    Both the condition (epilepsy) and some anti-seizure medicines have been associated with clefts. Doctors try to balance seizure control and drug safety when planning pregnancy. [17]

17. Thyroid and other endocrine problems in the mother
    Poorly controlled thyroid or other hormone diseases may contribute to abnormal fetal development and slightly raise the risk of clefts. [18]

18. Use of illicit drugs (for example, cocaine)
    These substances can narrow blood vessels and reduce blood supply to the baby. This can disturb normal formation of the lip and palate. [19]

19. Other chronic illnesses in the mother
    Heart disease, kidney disease, or autoimmune disorders in the mother may affect the pregnancy environment and can add to overall risk when combined with other factors. [20]

20. Unknown or unexplained causes
    In many babies with labium leporinum, no clear single cause is found. Even then, experts believe there is a combination of many small genetic and environmental influences. [21]

Symptoms and signs of labium leporinum

1. Visible split in the upper lip
   The most obvious sign is a gap, notch, or opening in the upper lip. It may be small or may go all the way into the nostril. This is usually seen immediately after birth or even on an ultrasound scan before the baby is born. [1]

2. Opening that extends into the nose
   In complete cleft lips, the split reaches up into the nose, and the nostril on that side may look larger or pulled out of shape. [2]

3. Changed shape of the nose
   The base of the nose and the cartilage can be twisted or flattened on the side of the cleft. This can make the nose look uneven. [3]

4. Feeding and sucking problems
   Newborns with cleft lip, especially when a cleft palate is also present, may have trouble making a good seal around the breast or bottle, so they may feed slowly or take in more air. [4]

5. Milk or formula coming out of the nose
   If the palate is also open, milk can go from the mouth up into the nose during feeding, because there is no solid barrier between mouth and nose. [5]

6. Poor weight gain or “failure to thrive”
   Because feeding can be hard, some babies do not gain weight as expected unless they get special feeding support, such as special bottles or help from a feeding specialist. [6]

7. Frequent ear infections
   Children with cleft lip and palate often have ear problems and repeated middle ear infections, because the muscles that open the ear tubes do not work normally. [7]

8. Hearing problems
   Fluid in the middle ear and repeated infections can lead to temporary or sometimes long-term hearing loss, which is why hearing tests and ear care are important. [8]

9. Nasal-sounding speech (hypernasal voice)
   When the palate does not close properly against the back of the throat, too much air escapes through the nose during speech, so the voice sounds very nasal. [9]

10. Difficulty pronouncing certain sounds
    Children may have trouble with sounds that need good lip closure (like “p” or “b”) or good palate closure (like “k” or “g”). Speech therapy is often needed even after surgery. [10]

11. Dental problems – missing, extra, or poorly shaped teeth
    Teeth near the cleft, especially the upper front teeth, may be missing, extra, twisted, or weak. This makes chewing and cleaning harder and can increase the risk of tooth decay. [11]

12. Misalignment of teeth and jaw (malocclusion)
    The upper jaw may grow differently because of the cleft. Teeth may not meet properly, causing bite problems like cross-bite or open bite. Orthodontic treatment is often needed. [12]

13. Difficulty chewing some foods
    Because of missing teeth, jaw problems, or a not-fully repaired palate, some children may find it hard to chew tougher foods and may take longer to eat meals. [13]

14. Breathing or snoring problems
    Some children have narrow nasal passages or other airway changes related to the cleft or its surgeries. This can cause snoring or mouth-breathing during sleep. [14]

15. Emotional and social difficulties
    Because the condition affects the face, some children and teenagers may feel shy, sad, or bullied. Support from family, counselors, and cleft teams can help protect self-esteem and mental health. [15]

Diagnostic tests for labium leporinum

Most cleft lips are easy to see at birth, so the main “test” is a careful look at the baby’s face and mouth. Extra tests are used to check feeding, hearing, other body systems, and to plan surgery. [1]

Physical exam tests

1. Newborn physical examination
   Soon after birth, a doctor or midwife checks the baby from head to toe. They look closely at the lip, nose, gums, and palate for any gaps or differences. They also examine the heart, limbs, and other organs to see if the cleft might be part of a wider syndrome. [2]

2. Detailed orofacial inspection
   A specialist (such as a plastic surgeon or craniofacial doctor) gently looks inside the mouth and around the nose and jaws. They check the size and shape of the cleft, whether it is unilateral or bilateral, and whether the palate is also involved. This exam helps plan the timing and type of surgery. [3]

3. Growth and nutrition assessment
   Doctors and nurses measure the baby’s weight, length, and head size over time. They compare these with growth charts to see if feeding problems are slowing growth. If growth is too slow, they adjust feeding methods or add more support. [4]

4. Ear, nose, and throat (ENT) examination
   An ENT doctor looks at the ears, nose, and throat to check for fluid behind the eardrum, narrow nasal passages, or other problems related to the cleft. They may use a small light or special tools to see clearly. [5]

Manual tests

5. Feeding and sucking assessment
   A feeding specialist or speech-language therapist watches the baby feed at the breast or bottle. They look at how the lips seal, how the tongue moves, and how much milk the baby takes in. If needed, they recommend special bottles or positions to make feeding safer and easier. [6]

6. Speech and articulation assessment (in older children)
   When the child is old enough to talk, a speech therapist listens to how they produce sounds and words. The therapist checks for nasal voice, unclear consonants, or compensatory speech habits and plans exercises or further treatment. [7]

7. Velopharyngeal function tests (simple mirror or air tests)
   In some clinics, therapists hold a small mirror under the nose while the child speaks. Fogging on the mirror shows air leaking from the nose. Simple manual tests like this help decide if the palate and throat are closing well during speech. [8]

8. Manual dental and bite examination
   A dentist or orthodontist gently checks the teeth and jaw by hand. They look for missing teeth, extra teeth, or cross-bite and feel how the upper and lower teeth meet. This helps decide when braces or other dental work should start. [9]

Lab and pathological tests

9. Routine blood tests (for surgical planning)
   Before surgery, doctors usually request basic blood tests such as a complete blood count and tests of clotting and general health. These tests make sure the baby is healthy enough for anesthesia and surgery and help reduce risks. [10]

10. Genetic consultation and testing
    If the cleft is severe, bilateral, or combined with other birth differences, a genetic specialist may be involved. Blood or saliva can be tested for chromosomal problems or gene changes linked to cleft syndromes. The results help parents understand future risks and related health needs. [11]

11. Syndrome-specific tests (for example, heart or kidney screening)
    When a known syndrome is suspected, extra blood tests or other investigations may be done to look for heart, kidney, or hormone problems that often come with that syndrome. This ensures that all health issues, not only the lip, are treated. [12]

12. Infection and immunity screening (pre-operative)
    Some hospitals test for infections such as hepatitis or HIV before surgery. This protects both the child and the surgical team and may change how the surgery is organized. [13]

Electrodiagnostic and functional tests

13. Hearing tests (audiometry or brainstem auditory responses)
    Because ear fluid and infections are common, hearing tests are important. In babies, doctors often use special machines that measure brain responses to sound (brainstem auditory evoked responses). These tests show how well the ears and hearing nerves are working. [14]

14. Electrocardiogram (ECG) before anesthesia
    An ECG is a quick test that records the heart’s electrical activity. It is often done before surgery to make sure the heart rhythm is normal, especially if the child has a syndrome that can affect the heart. [15]

15. Sleep and breathing studies (polysomnography) in selected cases
    If a child snores loudly, stops breathing in sleep, or has severe facial or jaw differences, doctors may order a sleep study. Sensors on the skin and around the head measure breathing, oxygen, and brain waves during sleep. This helps find sleep apnea or other breathing problems related to the cleft or its repair. [16]

16. Nerve function tests (for example, facial nerve studies in special cases)
    In rare cases where nerve injury or unusual facial movement is suspected, nerve conduction or EMG tests may be done. These measure how well the facial muscles and nerves work, especially after complex surgery. [17]

Imaging tests

17. Prenatal ultrasound scan
    Many cleft lips are seen on routine pregnancy ultrasound around 18–22 weeks. The person doing the scan looks carefully at the baby’s face in profile and from the front. If a cleft is seen, parents are referred to a specialist team for counseling and delivery planning. [18]

18. Prenatal MRI in selected cases
    In some centers, if the ultrasound picture is not clear or the cleft looks very complex, a fetal MRI may be done. This gives more detail about the baby’s face and brain and helps plan care after birth. It is usually reserved for complex or syndromic cases. [19]

19. Postnatal craniofacial CT scan or 3-D imaging
    When planning major jaw or facial surgery later in childhood, doctors may order a CT scan or 3-D imaging of the skull and face. These images show the bones, teeth, and nasal structures in detail and help surgeons plan bone grafts or jaw surgery. [20]

20. Dental X-rays and panoramic radiographs
    As the child grows, dentists use dental X-rays and panoramic images to look at tooth roots, missing teeth, and bone gaps in the gum line. This guides decisions about orthodontic treatment and bone grafting. [21]

Non-pharmacological treatments (therapies and others)

1. Feeding positioning and pacing: Hold the baby more upright, give slower feeds, and add breaks to reduce choking and tiredness. Purpose: safer feeding and better weight gain. Mechanism: gravity and slower flow help milk move the right way and reduce air swallowing.

2. Special cleft feeding bottles/teats: Use bottles designed for cleft feeding if a normal latch is hard. Purpose: help the baby drink enough milk. Mechanism: the teat shape and flow can work even when lip seal is weak.

3. Lactation and feeding-therapy coaching: Work with a trained feeding specialist to choose the best method for your baby. Purpose: prevent poor growth and stress. Mechanism: early skill training reduces fatigue and improves intake.

4. Burping strategy: Burp more often during feeds. Purpose: reduce gas pain and spit-up. Mechanism: babies with cleft often swallow more air; frequent burping releases it.

5. Weight-gain monitoring plan: Regular weight checks, sometimes weekly early on. Purpose: catch feeding problems early. Mechanism: growth tracking shows if calories are enough and if feeding changes are working.

6. Nasal saline and gentle suction (if blocked): Use saline drops and gentle suction when advised. Purpose: easier breathing during feeds and sleep. Mechanism: clears mucus so airflow improves.

7. Skin protection around the lip and nose: Keep the area clean and dry; use only products your clinician approves. Purpose: prevent irritation and infection. Mechanism: healthy skin supports better healing and comfort.

8. Pre-surgical taping: Some teams use adhesive taping to gently guide tissues before surgery. Purpose: make later repair easier in selected babies. Mechanism: steady gentle tension can reduce gap width over time.

9. Nasoalveolar molding (NAM): A custom device may shape gum and nose tissues before surgery. Purpose: improve nose and lip form before repair (not needed for every baby). Mechanism: guided molding slowly changes soft tissue position.

10. Early hearing checks: Hearing tests are important because ear fluid can affect hearing, especially when cleft palate is also present. Purpose: protect speech and learning. Mechanism: early detection allows early treatment.

11. Speech-language evaluation (planned follow-up): Even with cleft lip only, speech monitoring helps catch issues early. Purpose: best communication development. Mechanism: early therapy fixes small problems before they grow.

12. Dental and orthodontic planning: Teeth and jaw growth may need monitoring over years. Purpose: healthy bite, teeth alignment, and oral hygiene. Mechanism: staged dental care supports normal function and appearance.

13. Oral hygiene training for caregivers: Clean gums/teeth gently as advised. Purpose: reduce cavities and gum disease risk. Mechanism: less plaque means less inflammation and better long-term dental health.

14. Psychosocial support for parents and child: Counseling or support groups can help. Purpose: reduce stress and improve coping. Mechanism: shared planning and emotional support improve family wellbeing and follow-through.

15. Genetic counseling (when recommended): Some families benefit from learning about possible causes and future risks. Purpose: informed family planning and screening. Mechanism: risk review is based on family history and exam findings.

16. Sleep positioning guidance: Follow your clinician’s safe-sleep advice, especially if breathing is noisy. Purpose: safer sleep and feeding recovery. Mechanism: correct positioning supports breathing while protecting infant safety.

17. Post-surgery wound-care routine (non-drug): Gentle cleaning and protecting stitches as instructed. Purpose: prevent infection and scarring problems. Mechanism: clean wounds heal faster and with fewer complications.

18. Scar massage (only when cleared): After healing, some teams teach gentle massage. Purpose: softer, flatter scars. Mechanism: controlled pressure can help scar tissue remodel.

19. Sun protection for the scar: Use hats/shade (and sunscreen when age-appropriate) to protect the healing area. Purpose: reduce darkening and thick scarring. Mechanism: UV light can worsen scar color and texture.

20. Long-term team follow-up schedule: Planned visits through childhood. Purpose: coordinate surgery timing, speech, hearing, and teeth care. Mechanism: cleft care is staged; timing matters for best results.

Drug treatments (supportive medicines used around cleft-care)

Important: Cleft lip is mainly treated with surgery and therapy. Medicines are usually supportive (pain control, infection treatment, nausea control, reflux help). Doses are age- and weight-based, and your clinician chooses them.

1. Acetaminophen (paracetamol): Often used for mild to moderate pain after procedures. Class: non-opioid analgesic. Dosage/time: clinician sets a weight-based schedule for a short period. Purpose: comfort so feeding and sleep improve. Mechanism: reduces pain signaling in the body and brain. Side effects: liver injury if overdosed.

2. Ibuprofen: Used for pain and inflammation in some children when approved by the surgeon. Class: NSAID. Dosage/time: weight-based, short course. Purpose: lower swelling and pain. Mechanism: blocks prostaglandin production. Side effects: stomach irritation, kidney risk in dehydration, bleeding risk in some settings.

3. Amoxicillin: Sometimes used if a bacterial infection is suspected (not routine for every cleft repair). Class: penicillin antibiotic. Dosage/time: clinician-directed course. Purpose: treat infection. Mechanism: blocks bacterial cell-wall building. Side effects: allergy, diarrhea, rash.

4. Amoxicillin–clavulanate: Used when broader coverage is needed (doctor decision). Class: penicillin + beta-lactamase inhibitor. Dosage/time: clinician-directed. Purpose: treat certain bacterial infections. Mechanism: amoxicillin kills bacteria; clavulanate blocks resistance enzymes. Side effects: diarrhea, rash, allergy.

5. Cefazolin (injection): Commonly used by surgeons as an operating-room antibiotic in many surgeries (when appropriate). Class: cephalosporin antibiotic. Dosage/time: given by professionals around surgery time. Purpose: lower surgical infection risk in selected cases. Mechanism: blocks bacterial cell-wall building. Side effects: allergy, diarrhea.

6. Cephalexin: Sometimes used for skin/soft-tissue infections if needed. Class: cephalosporin antibiotic. Dosage/time: clinician-directed course. Purpose: treat bacterial infection. Mechanism: blocks bacterial cell-wall building. Side effects: allergy, stomach upset, diarrhea.

7. Clindamycin (injection/oral forms): Used when penicillin/cephalosporin can’t be used or when specific bacteria are suspected. Class: lincosamide antibiotic. Dosage/time: clinician-directed. Purpose: treat serious bacterial infections. Mechanism: blocks bacterial protein making. Side effects: diarrhea; risk of severe colitis in some people.

8. Azithromycin: Used for certain infections when appropriate. Class: macrolide antibiotic. Dosage/time: clinician-directed short course. Purpose: treat bacterial infection. Mechanism: blocks bacterial protein making. Side effects: stomach upset; rare heart rhythm risk in susceptible people.

9. Trimethoprim–sulfamethoxazole (TMP-SMX): Used for certain infections when a clinician chooses it. Class: sulfonamide antibiotic combo. Dosage/time: clinician-directed. Purpose: treat bacterial infection. Mechanism: blocks folate pathway in bacteria. Side effects: rash, allergy, sun sensitivity; special caution in some ages/conditions.

10. Chlorhexidine 0.12% oral rinse: Sometimes used by dental professionals for gum infection control (not for infants to swallow). Class: oral antiseptic. Dosage/time: clinician-directed rinse/spit routine in appropriate ages. Purpose: lower mouth bacteria. Mechanism: damages bacterial cell membranes. Side effects: tooth staining, taste change, irritation.

11. Lidocaine (local anesthetic, sometimes with epinephrine): Used by clinicians to numb tissues during procedures. Class: local anesthetic. Dosage/time: clinician-administered only. Purpose: pain control during procedures. Mechanism: blocks nerve signals. Side effects: heart/brain toxicity if too much enters blood.

12. Bupivacaine (local anesthetic): Often used for longer numbing after surgery (clinician use). Class: local anesthetic. Dosage/time: clinician-administered. Purpose: longer pain relief. Mechanism: blocks nerve signals for a longer time than lidocaine. Side effects: heart rhythm danger if overdosed.

13. Ondansetron: Used to prevent nausea/vomiting after anesthesia in some patients. Class: antiemetic (5-HT3 blocker). Dosage/time: clinician-directed around surgery. Purpose: reduce vomiting so the child can drink and recover. Mechanism: blocks serotonin signals that trigger vomiting. Side effects: headache; rare rhythm effects in susceptible patients.

14. Dexamethasone: Sometimes used by anesthesia teams to reduce nausea and swelling. Class: corticosteroid. Dosage/time: clinician-directed, usually short. Purpose: reduce inflammation and nausea. Mechanism: calms inflammatory signaling. Side effects: temporary mood/sugar changes; infection risk mainly with longer use.

15. Ketorolac: A strong NSAID used short-term for post-op pain in selected cases. Class: NSAID. Dosage/time: clinician-directed; labels limit duration. Purpose: reduce pain (sometimes opioid-sparing). Mechanism: blocks prostaglandins. Side effects: bleeding risk, kidney risk, stomach irritation; not for everyone.

16. Morphine (injection): Used for severe pain when non-opioids are not enough, under close monitoring. Class: opioid analgesic. Dosage/time: clinician-administered, short-term. Purpose: strong pain control. Mechanism: binds opioid receptors to reduce pain perception. Side effects: sleepiness, constipation, dangerous breathing slowing.

17. Fentanyl (injection): Used by anesthesia teams for pain control during surgery. Class: opioid analgesic. Dosage/time: clinician-administered. Purpose: control pain and stress response. Mechanism: strong opioid-receptor activation. Side effects: breathing suppression, chest stiffness in rare cases; requires monitoring.

18. Midazolam: Used for sedation/anxiety control before or during procedures (clinician use). Class: benzodiazepine. Dosage/time: clinician-directed. Purpose: calmness and short-term amnesia for stressful procedures. Mechanism: boosts GABA calming signals in the brain. Side effects: sleepiness, breathing suppression (especially with opioids).

19. Sevoflurane: A common inhaled anesthesia medicine used during surgery. Class: inhalational anesthetic. Dosage/time: clinician-controlled during operation. Purpose: keep the child asleep and pain-free during surgery. Mechanism: changes brain signaling to cause unconsciousness. Side effects: low blood pressure, nausea; rare serious reactions in susceptible people.

20. Omeprazole (oral suspension forms): Used if a child has reflux that affects feeding or growth (doctor decision). Class: proton-pump inhibitor (PPI). Dosage/time: clinician-directed, often time-limited. Purpose: reduce acid reflux discomfort. Mechanism: lowers acid production in the stomach. Side effects: diarrhea, headache; long-term use needs medical review.

Dietary molecular supplements (supporting nutrition and healing)

Note: Supplements do not “close” a cleft. They only help nutrition when diet is not enough. Ask a clinician before giving supplements to children, because doses depend on age and health.

1. Folate (folic acid): Helpful before and early in pregnancy to support normal baby development. Dosage: follow pregnancy guidance from a clinician. Function: supports DNA making and cell growth. Mechanism: provides folate for rapid cell division during early development.

2. Vitamin B12: Supports blood and nerve health, important if diet is low in animal foods. Dosage: depends on age and deficiency risk. Function: helps make DNA and healthy red blood cells. Mechanism: supports normal cell division and nerve function.

3. Iron: Used when iron is low or anemia is present. Dosage: clinician decides after tests. Function: helps carry oxygen in blood. Mechanism: supports hemoglobin production, helping energy and growth. Too much iron can be harmful.

4. Vitamin D: Supports bone growth and immune balance. Dosage: depends on age, sun exposure, and blood level. Function: helps calcium absorption. Mechanism: increases calcium uptake and supports bone mineral strength. Avoid very high dosing without medical advice.

5. Calcium: Supports bones and teeth, especially if diet intake is low. Dosage: based on age needs. Function: builds strong bones/teeth. Mechanism: supplies mineral for bone structure and muscle function. Too much can cause kidney issues in some people.

6. Zinc: Often discussed for wound healing and immune function. Dosage: age-based; avoid excess. Function: supports enzyme activity and tissue repair. Mechanism: helps cells grow and repair and supports immune signaling. Too much zinc can upset the stomach and affect copper balance.

7. Vitamin C: Supports collagen formation and wound healing. Dosage: age-based; avoid megadoses. Function: helps make collagen in skin and tissues. Mechanism: supports connective-tissue building and antioxidant defense. High doses can cause diarrhea and other issues.

8. Omega-3 fatty acids (DHA/EPA): Can support general health and inflammation balance. Dosage: depends on diet and age; clinician advice is best. Function: supports cell membranes and some anti-inflammatory pathways. Mechanism: provides fatty acids used in signaling molecules.

9. Choline: Important for cell membranes and brain development (especially in pregnancy). Dosage: follow life-stage guidance. Function: supports brain and cell structure. Mechanism: supplies building blocks for phospholipids and methyl groups.

10. Probiotics (strain-specific): Sometimes used to support gut comfort, especially after antibiotics (doctor advice). Dosage: depends on product and strain. Function: may support healthy gut bacteria. Mechanism: helpful strains can compete with harmful germs and support gut barrier function. Safety differs in premature or very sick infants.

Immunity booster / regenerative / stem-cell” drugs

Very important: There are no FDA-approved “stem cell drugs” that cure cleft lip. Regenerative or immune medicines are used only when a child has a separate diagnosed problem (for example, immune deficiency or severe wounds), and only under specialist care.

1. Filgrastim (G-CSF): Used for certain low-neutrophil conditions to reduce infection risk. Dosage: specialist-directed. Function: boosts white blood cell production. Mechanism: stimulates bone marrow to make neutrophils. Not a cleft treatment; only for diagnosed blood/immune issues.

2. Immune globulin (IVIG/SCIG): Used in some immune deficiencies. Dosage: specialist-directed. Function: provides antibodies. Mechanism: gives ready-made antibodies to improve infection defense. Not routine for cleft care; only when immune testing shows need.

3. Palifermin (keratinocyte growth factor): A regenerative-type medicine used in very specific settings to protect mouth lining (not cleft repair). Dosage: specialist-directed. Function: supports mucosal healing. Mechanism: stimulates growth of epithelial cells. Not used for typical cleft lip surgery.

4. Becaplermin (PDGF gel): A growth-factor gel for certain chronic wounds (not for surgical lip repair). Dosage: clinician-directed. Function: helps wound healing in select cases. Mechanism: supports cell migration and tissue repair signals. Not for routine cleft wounds.

5. Topical antibiotic ointments (selected cases): Sometimes used on skin wounds if a clinician advises. Dosage: small amounts, short time as directed. Function: reduce local bacterial growth. Mechanism: kills or inhibits bacteria on the skin surface. Overuse can cause irritation or resistance.

6. Vaccines (immune protection, not a “booster pill”): Staying up to date with routine vaccines helps protect infants and children from infections. Dosage/time: schedule-based. Function: trains immune memory. Mechanism: teaches the immune system to recognize germs faster later.

Surgeries (procedures and why they are done)

1. Primary cleft lip repair (cheiloplasty): The main operation to close the lip and improve shape. Why done: improve feeding seal, speech development support, and facial form. Usually done in infancy based on the child’s health and team plan.

2. Cleft rhinoplasty (nose repair, primary or secondary): Adjusts the nose shape that can be pulled to one side by the cleft. Why done: improve breathing through the nose and improve symmetry. Timing depends on the team and growth.

3. Lip revision surgery: A later “touch-up” if scar, shape, or symmetry needs improvement. Why done: function (lip seal) and appearance when the child is older.

4. Alveolar bone graft (if gum/alveolus is cleft): Places bone into the gum line when permanent teeth are coming. Why done: support teeth eruption, close gum gaps, and stabilize the upper jaw.

5. Orthognathic (jaw) surgery (selected teens/adults): Done if upper jaw growth is limited and bite is severe. Why done: improve chewing, speech balance, and facial profile after growth is near complete.

Preventions (risk-reduction before and during pregnancy)

Note: Not every cleft can be prevented, but risk can often be reduced.

1. Take folic acid as advised before pregnancy and early pregnancy to support early baby development.

2. Avoid smoking and secondhand smoke during pregnancy because smoking is linked with higher cleft risk.

3. Avoid alcohol during pregnancy because it can harm fetal development.

4. Control diabetes before pregnancy and during pregnancy with medical support.

5. Review medicines with a clinician before pregnancy, especially seizure medicines and other strong medicines.

6. Treat obesity with healthy lifestyle and medical support before pregnancy, because obesity is linked to some birth-defect risks.

7. Eat a balanced, nutrient-rich diet (enough protein, iron, folate, and vitamins).

8. Attend early prenatal care so risks are found and managed early.

9. Avoid harmful chemicals when possible (workplace solvents, pesticides) and follow safety rules.

10. Get genetic counseling when there is family history or previous child with a cleft.

When to see doctors

See a doctor immediately if a newborn has trouble breathing, turns blue, cannot feed, or is not gaining weight. Also seek care if milk comes out of the nose often with coughing/choking, if there are repeated ear infections or hearing concerns, or if a post-surgery wound has fever, spreading redness, bad smell, pus, or bleeding that does not stop. Regular cleft-team visits are important even when the child seems “fine,” because speech, hearing, and teeth changes can appear later.

What to eat and what to avoid (simple, practical)

1. Eat: Breast milk or formula in the safest method advised; Avoid: forcing feeds when baby is exhausted.

2. Eat: Frequent small feeds if needed; Avoid: long feeds that tire the baby.

3. Eat: High-calorie, nutrient-dense foods when older (eggs, yogurt, lentils, fish if allowed); Avoid: empty-calorie snacks replacing meals.

4. Eat: Iron-rich foods (meat, beans, fortified foods); Avoid: tea/coffee with meals for older kids if iron is low.

5. Eat: Vitamin C foods with plant-iron meals (citrus, guava, peppers); Avoid: relying on very high vitamin C pills.

6. Eat: Zinc foods (meat, beans, nuts as age-safe); Avoid: high-dose zinc without advice.

7. After lip surgery eat: soft, smooth foods as advised (purees, soups, mashed foods); Avoid: hard, sharp, crunchy foods that can hurt stitches.

8. After surgery eat: plenty of fluids; Avoid: dehydration, because it worsens recovery and constipation.

9. Eat: Calcium + vitamin D sources (milk, yogurt, fortified foods); Avoid: excessive supplements when diet is enough.

10. Eat: Balanced meals with protein (fish, chicken, lentils) for healing; Avoid: skipping meals during recovery.

FAQs

1. Is labium leporinum the same as cleft lip? Yes. It is an older term that means cleft lip.

2. Did parents cause it? Most of the time, no single cause is found. It usually comes from a mix of genes and pregnancy factors.

3. Can cleft lip be seen before birth? Often yes, ultrasound can detect it, but not always.

4. Will my baby be able to feed? Most babies can feed well with the right technique and, if needed, special bottles.

5. Does cleft lip always mean cleft palate? No. Some babies have cleft lip only; others have both.

6. When is surgery usually done? Timing depends on health and the cleft team plan, but repair is commonly done in infancy.

7. Will my child need more than one surgery? Some children need later nose, scar, gum (bone graft), or jaw procedures, depending on growth and cleft type.

8. Will speech be normal? Many children do very well, but speech checks help catch problems early, especially if palate is involved.

9. Are ear infections common? They can be, especially when cleft palate is present, so hearing follow-up matters.

10. Do medicines cure cleft lip? No. Medicines support recovery (pain, infection, nausea), but surgery and therapy fix the cleft.

11. Is scarring always severe? Not always. Good surgical technique, proper wound care, and sun protection can improve scar appearance.

12. Can a future pregnancy have the same problem? Risk can be higher with family history, but it varies; genetic counseling can help explain it.

13. Does folic acid prevent all clefts? No, but folate supports early development and is part of risk-reduction care.

14. Are “stem cell cures” real for cleft lip? No FDA-approved stem cell drug cures cleft lip; be careful with online claims.

15. What is the best first step after diagnosis? Join a cleft/craniofacial team, set a feeding plan, and follow the staged care timeline.

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.