A cleft lip occurs when an infant’s lip tissue doesn’t fuse all the way before birth, resulting in an opening in the upper lip. This opening can be a small slit or can be so large that it goes through the lip and into the nose. A cleft palate occurs when the tissue that makes up the roof of the mouth does not fune completely, resulting in an opening in the front and/or back of the palate. Some babies are born with both a cleft lip and cleft palate (boys are more likely to develop a cleft lip with or without a cleft palate; girls are more likely to have a cleft palate without a cleft lip). While the cause of an orofacial cleft remains unknown, there are several factors that can contribute to this condition, specifically if the mother smokes, drinks, or takes medication to treat epilepsy. Children born with orofacial clefts often have trouble eating and speaking clearly. They also are at high risk for developing repeat ear infections. Surgery can successfully repair cleft lip and cleft palate and is usually recommended within the first few months of the baby’s life. In some cases, the initial surgery is enough to fix the issue. However, many children need additional surgeries and speech therapy.