An infant with cleft lip and palate can't suck properly, making breastfeeding difficult or impossible. Most babies will need to be bottle fed, with breast milk or formula, using special nipples. You may need to try a variety of nipples and bottles to find what works best for your baby. A nurse from the Craniofacial Anomalies Center will meet with you as soon as possible after your baby's birth to develop a successful feeding plan. It's important for your child's pediatrician to perform weekly weight checks to make sure your child is gaining enough weight.
Soon after birth and in preparation for surgery, the cleft lip may be taped to help reduce the width of the cleft.
Since ear infections are more common in children with cleft palate, we recommend a hearing test to determine whether ventilating tubes, which reduce the risk of ear infections, should be placed in the ears at the time of the palate surgery. In addition, an eye examination is usually recommended because eye anomalies are sometimes found in children with cleft lip and palate.
The lip cleft is usually repaired when the infant is around 10 weeks old or weighs 10 pounds. This surgery takes two to three hours and the child usually stays in the hospital for one night.
The cleft palate is generally repaired when the baby is around 10 months old or starting to make sounds of speech. Palate surgery usually takes two to three hours, with the infant staying in the hospital one or two nights. Although speech is generally normal after cleft palate repair, some children may need speech therapy and possibly a second palate surgery.
Most children also need orthodontic treatment with braces and alveolar bone grafting to fill the remaining gap in the gum line. The first phase of treatment is usually to widen the upper jaw with an orthodontic appliance when the permanent first molars and front teeth have come in, at around 7 years of age. Bone grafting surgery is done after the widening is complete.
A child with a cleft lip and palate may encounter social and emotional challenges unique to this condition. Support organizations and resources are available for children with clefts and their families.
Because this birth defect may have a genetic link, families may be referred to the General Genetics Clinic for counseling.
Reviewed by health care specialists at UCSF Benioff Children's Hospital.