Cleft Lip & Palate
Overview
The CDC estimates about 2650 babies are born born with a cleft palate and 4,440 babies are born with a cleft lip (with or without a cleft palate) each year in the United States.
Children with these congenital problems are usually managed in a multi-specialty cleft clinic. Babies with cleft lips usually undergo repair in the first few months of life while palate repair is performed during the first year to 18 months.
The baby usually spends one night in the hospital. Full recovery may take 1-2 weeks and the child often needs additional surgeries as they grow older.
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Restore the Function of Your Child’s Mouth
Cleft lip and cleft palate are some of the most common birth anomalies that children around the world experience. A cleft lip is the incomplete formation of the upper lip, while a cleft palate refers to a separation on the roof of the mouth.
These defects can happen together or individually and may affect one or both sides of a child's mouth. A child with a combination of these will need corrective surgery to use their mouth normally.
Cause and Correction
Cleft lips and/or palates occur early in your unborn baby's development, and the cause is often unknown. Sometimes and identifiable syndrome will keep the upper lip and roof of the mouth from growing together. However, for most affected children, this isn't the case. A complex interaction of genetic and environmental factors may cause many clefts.
Cleft lip and cleft palate surgeries correct this abnormal development to restore your child's lips and mouth function. They also give the areas a more normal appearance.
Specialized plastic surgery techniques can repair most clefts and improve your child's ability to eat, speak, hear and breathe.
A Team Effort
Early intervention by a team of specialists is the best way to manage your child's treatment development. Your team will work together to create a treatment plan. The plan will include feeding rehabilitation and dental restoration. Your specialist team might consist of a:
- Plastic surgeon
- Pediatrician
- Pediatric dentist
- Orthodontist
- Otolaryngologist (ear, nose and throat specialist)
- Lactation Specialist
- Occupational therapist
- Auditory or hearing specialist
- Speech-language pathologist
- Genetic counselor
- Psychologist
- Social worker
Your child's growth and development, as well as their ability to eat, will be the top priority at the earliest stages of care.
Your child may need specialized bottles, or in rare cases, a feeding tube, to eat well before a cleft is corrected.
When a child has a cleft palate, they won't breastfeed normally due to problems with creating oral suction.
More Than Just Appearance
Every surgery to repair a cleft lip and/or palate is unique. The primary purpose of the surgery is to improve your child's ability to function and grow normally.
- Cleft lip repair, also called cheiloplasty, will reconstruct the lip to create normal function and appearance. This process includes:
- Closing the cleft. The resulting scar will be close to the typical features of the upper lip.
- Creating a cupid's bow (the curves in the center of the upper lip)
- Establish an average distance between your child's upper lip and nose.
If your child's cleft lip affects the shape of their nose, we may recommend additional procedures to:
- Restore symmetry and nostril shape.
- Straighten and create enough space for the tissue that separates the nostrils.
There are more factors to consider when correcting a cleft palate because the palate is responsible for normal speech and hearing. Corrective surgery will:
- Close the cleft along its length to separate the mouth and nasal tissues.
- Re-establish muscle function in the soft palate to allow for normal speech.
- Recreate a normal relationship between the soft palate to the auditory canal and the Eustachian tube so your child can hear normally.
- Promote the normal growth and development of your child's upper jaw and teeth.
- If necessary, repair problems in the gum line so permanent teeth can erupt correctly.
Timing of the Surgery
The ideal time for corrective surgery will be different for every child.
Cleft lip repairs are typically performed between two and six months of age. This will depend on your child's health and your team's protocols.
Cleft palate repairs are performed in a separate surgery when your child between 9 and 18 months of age.
If your child has more life-threatening problems, such as a heart or lung disorder, those will be treated first.
Depending on how severe the cleft is, we may recommend pre-operative interventions as cleft lip taping, orthodontic molding (called NasoAlveolar Molding – NAM), or staged surgery techniques.
Your child may need other cleft-related surgeries may be necessary later on. These might include ear tubes to treat fluid buildup, bone grafting to repair the gum line, and dental or jaw surgery to improve your child's bite.
