Cleft lip and palate - Symptoms of cleft lip and palate

The symptoms of a cleft lip and palate can vary depending on which area is affected.

There are two types of cleft lip:

• unilateral cleft, where the cleft occurs on one side of the lip
• bilateral cleft, where the cleft occurs on both sides of the lip

The appearance of the cleft lip can vary from a small notch in the lip (incomplete cleft) to a wide gap that runs all the way up to the nostril (complete cleft lip).

The appearance of a cleft palate can range from an opening at the back of the soft palate to a complete cleft of the roof of the mouth (hard and soft palate).

Whilst a cleft of the lip is usually fairly obvious, a cleft palate is hidden inside the mouth and may not be easily visible. However, most cleft palates are picked up soon after birth. If there are feeding difficulties soon after birth, such as a failure to suckle or frequent escape of milk down the nose during feeding, then the palate should be carefully examined by a health professional.

Hidden cleft palate

Cleft lip and palate is visible at birth. However, a type of cleft palate called a submucous cleft palate can be hidden by the lining of the roof of the mouth. This type of cleft palate can be difficult to diagnose early on and in some cases may not be apparent for some months or years.

You should take your child to see your GP if they develop the following symptoms:

• milk frequently comes out of the nose when feeding
• an inability to suck through a straw or blow out candles
• nasal-sounding speech

These symptoms may indicate a submucous cleft palate.

Pierre-Robin cleft palate

Some children with a cleft palate may also have a small or 'set-back' (retruded) lower jaw. This may cause the tongue to interfere with the upper airway and breathing. This combination of features is called Pierre-Robin sequence.

A Pierre-Robin cleft palate may lead to difficult and noisy breathing. Breathing difficulties can be managed by careful positioning of the infant or sometimes by placing a special breathing tube into the nose. In very severe cases, a tracheostomy may be required.

In most cases, the lower jaw grows and catches up during the first few months. It is quite common for this type of cleft palate to be repaired a little later than usual, often around one-year of age.

Learn more about diagnosing cleft lip and palate.