In medicine, CLP stands for cleft lip and palate — an opening in the upper lip, in the roof of the mouth, or in both, present at birth. It is one of the most common birth defects in the United States, and it is highly treatable: with today's team care, almost every child born with a cleft grows up eating, speaking, and smiling normally.
What does CLP stand for in medical terms?
CLP is the standard medical abbreviation for cleft lip and palate. Related short forms:
- CL – cleft lip only
- CP – cleft palate only
- CL/P – cleft lip with or without cleft palate
- UCLP / BCLP – a one-sided or two-sided cleft involving lip and palate
- VPI – velopharyngeal insufficiency, a speech problem that can follow a repair
CLP means both structures are involved; CL or CP alone means that only a cleft palate or cleft lip is present. The research literature also writes it as cleft of lip and palate. One word to avoid is "harelip": it is outdated, inaccurate, and offensive. Clinicians and families use person-first language — a baby who has a cleft, never a "cleft baby."
What is cleft lip and palate?
A cleft occurs early in pregnancy, when the tissues that build the face do not fully join. Between about the fourth and tenth week, plates of tissue grow toward the midline and fuse. If that fusion stays incomplete, an opening remains — a cleft of the lip, a cleft palate, or both.
A cleft lip is a gap in the lip: anything from a small notch in the red border to a wide split running from the upper lip into the base of the nose. A cleft palate is an opening in the roof of the mouth. It can involve the soft palate at the back, the bony hard palate further forward, or both, leaving the mouth and nasal cavity connected.
Because these structures form separately, an orofacial cleft — also called an oral cleft — may involve one of them or several. Nothing an expectant parent did or thought caused it.
What are the types of cleft lip and cleft palate?
Cleft lip with or without cleft palate
A cleft lip may be incomplete, stopping partway toward the nostril, or a complete cleft reaching into the nose and often through the gum ridge. The mildest form of cleft lip is a small notch in the red border. A unilateral cleft affects one side of the upper lip; a bilateral cleft affects both and leaves a small central segment. Roughly seven in ten babies with cleft lip also have a cleft palate.
Cleft palate without cleft lip
Here the roof of the mouth does not close but the lip is intact. It may involve only the soft palate, or extend forward toward the gum. Isolated cleft palate is easy to miss unless a newborn's palate is looked at and felt directly.
Submucous cleft palate
In a submucous cleft palate the muscle layer is split while the overlying lining stays intact, so there is no visible opening. Signs include a bifid (split) uvula and a notch at the back edge of the bony palate. Some children never have symptoms; others develop nasal-sounding speech and are diagnosed years later.
One side or both sides
Unilateral cleft lip and palate is the most common pattern, affecting the left side more often than the right; bilateral cleft lip and palate is less common and usually needs a more staged plan. Teams also record the severity of the cleft, because narrow and wide openings need different repairs.
How common is this birth defect in the United States?
According to the CDC, about 1 in every 1,031 babies is born with a cleft lip, alone or together with a cleft palate, and cases of cleft palate occur on their own in about 1 in every 1,563 births.
Clefts involving the lip and palate are most common in boys, while a cleft palate on its own is seen more often in girls. Cleft lip is more common in some ancestries than others, with the highest rates reported among American Indian and Alaska Native populations. Cleft lip and cleft palate are among the birth defects that state programs track continuously.
What are the causes of cleft lip and palate?
The etiology of cleft lip and palate is multifactorial: many genes each add a small amount of risk, and exposures in the first trimester can tip the balance. Around seven in ten cases of cleft lip are non-syndromic cleft lip and palate, meaning the cleft appears on its own. The rest belong to a genetic syndrome — more than 400 syndromes are associated with cleft palate, among them Van der Woude, 22q11.2 deletion, and Stickler syndrome.
Risk factors identified by the CDC and NIDCR include:
- Smoking during pregnancy, the most consistently reported factor.
- Diabetes diagnosed before pregnancy.
- Certain anti-seizure medications, such as topiramate or valproate.
- Heavy alcohol use and poor nutrition in early pregnancy.
- A family history of cleft lip or palate in a parent or sibling.
Stress, a fall, or a mother's thoughts during pregnancy do not cause clefts; these myths persist and create real, unnecessary guilt.
Can it be prevented?
Not entirely, because much of the risk is genetic. But several steps lower the risk of cleft lip and of birth defects generally: stop smoking and drinking before conception, take 400 micrograms of folic acid daily from before pregnancy, keep diabetes controlled, and review every prescription with your doctor.
How is cleft lip and palate diagnosed?
A cleft lip is usually visible on the routine mid-pregnancy ultrasound at about 18 to 22 weeks. A prenatal diagnosis gives the family months to meet the team and arrange feeding support.
A cleft palate alone is far harder to see on ultrasound, so it is often found only at the newborn examination — which is why every baby's palate should be checked after birth. A cleft hidden beneath intact lining can go unrecognized until a toddler's speech sounds nasal. A baby with cleft lip or cleft palate is referred to a specialist team as soon as the diagnosis is made.
How do you feed a baby with a cleft?
Feeding is the first practical worry for most parents, and it is usually solved within days. A cleft lip alone rarely stops a baby from breastfeeding: breast tissue can seal the opening, and a finger can close a small gap.
A cleft palate is different: babies with cleft palate cannot generate suction, because air escapes through the opening into the nose. They swallow normally, so the milk has to be delivered rather than drawn out. A baby born with cleft palate is fed with a specialty bottle that has a one-way valve or a squeezable reservoir — the Haberman, Dr. Brown's, and Pigeon systems are widely supplied in the US. Expressed breast milk works well in them.
A feeding specialist covers the practicalities: hold the baby upright, expect feeds of 20 to 30 minutes, burp often, and treat a little milk coming back through the nose as normal. Weight gain is the number that matters, and infants with cleft lip and palate are weighed closely before surgery.
What does treatment of cleft lip and palate involve?
The treatment of patients with cleft lip and palate is a sequence, not a single operation. It is coordinated by a cleft lip and palate team: a plastic or craniofacial surgeon, an ENT surgeon, a speech-language pathologist, an orthodontist, a pediatric dentist, an audiologist, and a psychologist. A child with a cleft lip and palate usually meets most of them before the first birthday.
In the United States, the American Cleft Palate-Craniofacial Association (ACPA) publishes standards of care and approves teams that meet them; this national cleft palate association lists approved teams so families can find one nearby. Choosing an experienced cleft team early matters more than almost any later decision. Most teams complete lip and cleft palate repair within the first 18 months of life.
Cleft lip repair: plastic surgery at 3 to 6 months
Surgery to repair a cleft lip is usually done in the first months of life. Where the opening is wide, some teams first narrow it with nasoalveolar molding — a plate worn in the mouth — or lip taping. The plastic surgery rebuilds the muscle ring of the lip, the red border, and the base of the nostril in one operation. The scar follows the natural line from nostril to lip and fades considerably.
Palate repair at 9 to 18 months
The operation to repair a cleft palate is timed before a child's speech patterns are set. The surgeon closes the opening in layers and repositions the palate muscles so they can seal against the back of the throat for normal speech. Ear tubes are often placed under the same anesthetic. Cleft palate and cleft lip are closed separately, because the two structures are ready at different ages.
Alveolar bone graft at 8 to 11 years
If the cleft crosses the gum ridge, a bone graft fills it, usually with cancellous bone from the hip. It is timed before the permanent canine erupts, so that tooth can move into solid bone. The graft also stabilizes the dental arch and creates the bone volume any later implant will need.
Orthognathic surgery after growth is complete
Some teenagers finish growing with an upper jaw that sits too far back. Jaw surgery at about 16 to 20 years moves the maxilla forward to correct the bite and the profile. Cleft lip and palate repair is best understood as a two-decade pathway, not a single event.
Will my child need speech therapy?
Many children do, and it is a normal part of care. Even after a well-healed repair, some children cannot fully close the space between the palate and the throat — velopharyngeal insufficiency — which makes speech sound nasal.
Most speech differences respond to therapy. When the problem is structural rather than learned, a procedure such as a pharyngeal flap can restore the seal. Hearing matters just as much: a cleft palate may let fluid build up behind the eardrum, and untreated middle-ear fluid slows speech development, so hearing is checked at every visit.
What dental and orthodontic care will a child with cleft lip and palate need?
Children with cleft palate and clefts that cross the gum ridge often have teeth that are missing, extra, rotated, or unusually shaped — most often the lateral incisor beside the cleft. Enamel defects are common there too, so a pediatric dentist should see the child by the first birthday and keep prevention tight.
Orthodontics comes in phases: an early phase at about 6 to 9 years widens a narrow upper arch and prepares the site for the bone graft, then full braces in the teens aligns the permanent teeth. Crossbites and a set-back upper jaw are managed alongside the surgical plan for tooth and jaw deformities. Cleft lip and palate may also affect the shape and position of individual teeth for life.
Missing teeth and dental implants in adults with a repaired cleft
Even after excellent pediatric cleft lip and palate care, many adults reach their twenties with a permanent gap where the lateral incisor never formed. That is tooth loss in one specific spot, and it is restorable.
The site does need preparation. Bone in a repaired cleft is often narrow or resorbed, so bone grafting and augmentation is usually the first step, followed by several months of healing before an implant is placed. Systematic reviews report success rates for dental implants in bone-grafted cleft sites approaching those in non-grafted bone, with outcomes depending on graft quality and soft-tissue management.
Where treatment is possible, a single dental implant replaces the missing tooth without touching the neighboring teeth. Where it is not, a dental bridge or orthodontic space closure remains a good alternative. Adult cleft lip and palate patients are best planned by a surgeon and implantologist experienced in grafted sites — use our expert search to find one near you.
Will a cleft lip and palate happen again?
For non-syndromic clefts, the recurrence of cleft lip and palate in a later pregnancy is typically quoted at roughly 2 to 5 percent when one child is affected — higher than the background risk, but still meaning most later pregnancies are unaffected. The figure rises if a parent also has a cleft. A genetic counselor can give you a number that fits your family.
Is a cleft lip a disability, and what is the outlook?
A repaired cleft is not, for most people, a disability. Under US law a condition counts as a disability when it substantially limits a major life activity, so a child whose speech or hearing is significantly affected may qualify for services, while an adult with a healed repair and typical speech generally would not. Schools can provide support through an IEP or a 504 plan either way.
The long-term outlook is genuinely good. Individuals with cleft lip and palate reach normal life expectancy, normal intelligence, and normal educational and career outcomes. Some young people need help with teasing or self-image, which is what the team psychologist is for. The destination for nearly every child with cleft lip and palate is an ordinary adult life.
Frequently asked questions about cleft lip and palate
What is the main cause of cleft lip and palate?
There is usually no single cause. Most clefts result from many small genetic risk factors combined with first-trimester exposures such as smoking, pre-pregnancy diabetes, or certain anti-seizure medications. Roughly 30 percent of cases form part of a genetic syndrome.
At what age is a cleft palate closed?
Most teams close the palate between 9 and 18 months of age, before speech patterns are established. The lip is usually repaired earlier, at around 3 to 6 months. Exact timing depends on the baby's weight, health, and the width of the opening.
How do you feed a newborn with a cleft palate?
They cannot create suction, so they are fed with a specialty bottle that delivers milk through a one-way valve or a squeezable reservoir. Expressed breast milk can be given in the same bottle, and a feeding specialist sets this up in the first days of life.
Can adults with a repaired cleft get dental implants?
Yes, in many cases. The missing tooth at the cleft site can often be replaced with an implant, though the area usually needs bone grafting first and several months of healing. A surgeon experienced in grafted cleft sites should assess bone volume with 3D imaging.
Sources
- CDC – Cleft Lip/Cleft Palate – US prevalence estimates (about 1 in 1,031 and 1 in 1,563), risk factors, diagnosis and treatment timing.
- NIDCR (NIH) – Cleft Lip and Palate – definition, share of syndromic cases, team-based care, surgery timing.
- Mayo Clinic – Cleft lip and cleft palate – symptoms, complications, prevention.
- NHS – Cleft lip and palate – appearance, related problems, treatment pathway, recurrence.
- ACPA – Team Care and ACPA – Parameters of Care – US team-care standards and approved team listings.
- PubMed – Alveolar Bone Grafting and Cleft Lip and Palate: A Review – timing and purpose of alveolar bone grafting.
- PubMed – Effectiveness, Esthetics, and Success Rate of Dental Implants in Bone-Grafted Regions of Cleft Lip and Palate Patients – implant outcomes in grafted cleft sites.
- PubMed – Dental implants in cleft lip, alveolus, and palate patients: a systematic review – supporting evidence for adult implant treatment.
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