How is cleft lip and palate treated?

Reviewed by Kristie Rivers, MD, FAAP, Board Certified Pediatrician

Children born with cleft lip and/or palate can face a variety of challenges. For their parents, that includes how and when to treat the cleft.

Depending on the severity of the cleft, complications can include difficulty feeding and/or swallowing, frequent ear infections, and speech difficulties.

Fortunately, cleft lip and palate can be repaired. Surgery is recommended when your baby is the right age and size, typically before the first birthday.

During the procedure, your child will remain under general anesthesia in the operating room, where the surgeon will join the separated tissue and muscles of the lip and/or palate to close the split.

Different procedures are used to fix clefts and their resulting complications. In addition to the cleft repair, for example, ear tubes may also be inserted to reduce the reoccurrence of ear infections.

A team of specialists will be involved in your child’s care, including your pediatrician, a plastic surgeon, a pediatric dentist, an ear, nose, and throat (ENT) specialist, and a speech therapist. While this may be overwhelming as a parent, it is your right to advocate for your child and yourself. Ask questions of the health care team, like, “Am I allowed in the recovery room?” and “What restrictions will my child have after surgery?”

After the operation, your doctor will tell you when it is safe to feed your child liquids and then soft foods, if age-appropriate. After every feeding, rinse your child’s mouth with water to keep the area clean. Your child may spit up food or liquid until the swelling goes down and the palate muscles begin to function.

Your child’s doctor may also suggest specific supplemental treatments. These treatments might include speech therapy to correct speaking difficulties or a hearing aid to help with hearing loss.

Over time, additional surgeries may become necessary. Some children require another operation, called a pharyngeal flap, to fix nasal airflow during speech. Others may need a bone graft to help the gum line support teeth. Cosmetic surgeries can improve the appearance of the nose and lips, and braces may be suggested to straighten permanent teeth.

Cleft treatments often take place over a long period of time and can require multiple procedures, but these procedures can markedly benefit your child’s appearance, eating, hearing, and speech.

Reviewed by Dr. Sara Connolly, December 2018