Q&A: I would like to have another child, but my first was born with a cleft lip and I am concerned.

It is so hard to go back into a pregnancy when something untoward happened in the past. Even though cleft lip is reparable, you know it causes a lot of stress and expense, and you feel bad for the child (and family) having to endure it all.

Several factors play a role in the chance of recurrence of cleft lip. Like many conditions, isolated cleft lip (meaning cleft lip without cleft palate and not part of a known genetic syndrome) is considered multifactorial. Genetic and environmental factors play a role. The chance of recurrence in a sibling is dependent on the sex of the sibling with the cleft lip, the sex of the new baby, and the severity of the cleft—if it one-sided or bilateral. Overall, the chance is increased over the general population risk of one in 500 but is likely to be less than 5 percent.

The best way to get information specific for your situation is to talk to a genetic counselor. Genetic counselors have access to huge amounts of information to help you assess the odds, and also are trained as counselors to help you make the reproductive decisions that are right for your family. You can find a genetic counselor through your doctor or midwife.