The risk of recurrence of a cleft condition in the family depends upon a number of factors. These include the number of affected members in the family, the proximity of the affected relatives, the race and sex of all affected person, and the severity of cleft. If one family member is affected, roughly 5-10% chances that next baby will have cleft. If two members of family are affected, roughly 15% chances that next baby will have cleft. A genetic counselor provides information about the risk of having other children with the same defect.

In order to study the causes of clefting, clefts are categorised into two groups. Those that are associated with changes of the function or formation of other parts of the body are called syndromic clefts. The large majority, are not associated with changes elsewhere in the body and are called non-syndromic clefts or isolated clefts. It is important for a syndrome to be recognised, because accurate diagnosis enables accurate genetic counselling.

Genetic testing is available for some syndromes to confirm the diagnosis and detect, the presence of the gene and its carriers. If no syndrome is detected on physical examination, no further tests are usually required. Often a paediatrician is the first person to detect features suggestive of a syndrome, and this often leads to referral to a genetics service to determine or confirm if a syndrome is present.