Cleft Lip and Palate

Birth and Bonding

About 1 in 700 babies in Europe are born with a cleft lip and/or palate*. 

It is common for expectant mothers and fathers to be anxious about the birth of a baby diagnosed with a cleft lip and some parents expressed concerns about their ability to bond with a baby that might look different.

However, some babies only have a cleft palate and this can be diagnosed pre-natally by a 3D scan but is usually diagnosed by health professionals after the baby is born. For many parents it is a shock to have a child born with a cleft particularly if it was not diagnosed before birth.

Babies born with a cleft lip and/or palate can have gaps in their lip on one side only (unilateral) or on both sides (bilateral). Most are born naturally in hospital; home births are not encouraged if it is known that a baby has a cleft lip so that a paediatrician can check the baby early for additional problems such as a heart murmur and other associated complications such as cleft palate.

After the baby with cleft is born a Clinical Nurse Specialist (CNS) will visit the family within 24 hours if in England and Wales. Occasionally a diagnosis of a cleft palate is missed by health professionals (See ‘Late diagnosis of cleft’). 

In rare cases the baby will be looked after in a Special Care Baby Unit (SCBU) – this is usually because the baby has feeding problems. In the SCBU the baby will be fed by mouth unless it is premature baby or has a syndrome – if so, a naso-gastric tube will be used (a tube that goes through the nose into the baby’s tummy; see ‘Feeding a baby born with a cleft’). In rarer cases a baby born with a cleft may have breathing problems and /or suspected associated conditions (Pierre Robin Sequence, Stickler syndrome) and these will also be looked after in SCBU. 

Having a baby taken to SCBU can be distressing for new parents but despite the shock of being separated from their new baby parents who have a child born with a cleft lip and/or palate still have lots of opportunities to bond with their new baby. 

Parents are allowed spend time with their babies on the SCBU and shown how to feed their baby by a specially adapted bottle or, sometimes, a naso-gastric tube. Most parents we spoke to felt well supported by the clinical nurse specialists, midwives and other health professionals working in the SCBU. However, some find this aspect of care more difficult and don’t always feel comfortable when they go to the SCBU.

Through conducting our interviews with a range of mothers and fathers of children born with cleft lip a visible difference at birth does not appear to taint the joy of birth and the ability to bond with the baby.


* World Health Organisation. Global Registry and Database on Craniofacial Anomalies Eds:
Mossey PA, Castillia (2003). WHO Reports, Human Genetics Programme: International
Collaborative Research on Craniofacial Anomalies, WHO publications, Geneva, Switzerland

Last reviewed June 2017.

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