What are the symptoms? There are two types of cleft lip: unilateral cleft – where the cleft occurs on one side of the lipbilateral cleft – where the cleft occurs on both sides of the lip. The appearance of the cleft lip is variable among babies. It can be an incomplete cleft (a small notch in the lip) or a wide gap that runs all the way up to the nostril (complete cleft lip). The appearance of a cleft palate can be anything from an opening at the back of the soft palate towards the throat to an almost complete separation of the roof of the mouth. What are the causes? A cleft lip and/or palate can occur in isolation or be part of a specific syndrome, such as Pierre Robin syndrome. The risk of a cleft lip and/or palate may be increased by: certain medications being prescribed during pregnancy, such as phenytoin (a drug used to control seizures in epilepsy)drinking a large amount of alcohol during pregnancymaternal smokingmaternal infection during pregnancy. In a large majority of cases, the cause of a cleft lip and/or palate is not known. How is it treated? A cleft lip is usually repaired surgically on the NHS at about three months and cleft palate at 6 to 12 months of age. Infants with clefts of the lip and/or palate should be referred to a specialist cleft clinic. The team at these clinics will be made up of various specialists, including: a specialist cleft nursea cleft surgeonan orthodontista paediatric (children’s) dentista speech and language therapista psychologistan audiologist and ear, nose and throat (ENT) surgeon a paediatrician. Once surgical repair of a cleft lip and/or palate has occurred follow-up assessment and treatment will occur. This includes speech and language assessment and orthodontic assessment. Inheritance patterns and prenatal diagnosis Inheritance patternsCleft lip and/or palate can sometimes run in families, suggesting a genetic predisposition. The risk of recurrence increases with the number of affected people in a family. Occasionally the condition is part of another inheritable syndrome. Genetic counselling should be offered. Prenatal diagnosisClefts of the lip are often found on the 18 to 20-week ultrasound during pregnancy. Referral should then be made to a cleft team for discussion. Is there support? Cleft Lip & Palate Association (CLAPA) Tel: 020 7833 4883Email: firstname.lastname@example.orgWebsite: clapa.com The Association is a Registered Charity in England and Wales No. 1108160. It provides information and support to those affected by cleft lip and palate and Pierre Robin Syndrome. The Association offers local parent-to-parent support through a nation-wide network, runs a specialist feeding service, and supports children and adolescents at school and in social settings. Group details last updated October 2014.