When your baby is born with cleft, the delivery room nurse
usually calls the cleft palate program for initial evaluation.
Please see Newborn Nursery
- The first surgery, your child will have is the repair of
cleft lip and rebuild muscles and tissues around his mouth and
- Your baby should be at least 10 pounds, and with no other
medical problems that will put your baby at higher risk for
- The surgery takes about an hour and a half, and your child
may be able to go home on the same day.
- Your child may have some discomfort from the cleft area after
surgery, you may give your child some pain medicine. (please
follow the instructions given to you by the prescribing
6 to 10 Months:
- Your child should have a hearing test on or before 6 months
- An Occupational therapist should follow up your child to
transition to semi solid feedings, cup drinking and weaning off
from the bottle instruction and to address any other feeding
10 to 12 Months:
- Surgery to close the palate (palatoplasty) along with ear
tube placement (if recommended by the Otolaryngologist).
- Your child should be at least 17 pounds and off the bottle.
3 to 5 Years:
- Second surgery to repair the lip and nose. Scar tissue from
the first surgery does not grow as fast as normal tissue, pulling
the skin of the lip and nose out of place again.
- Repair of palate fistula (as the roof of the mouth heals from
the first surgery, the muscles pull and small holes may result.
- Speech therapist follow-up, to determine need for speech
- Psychosocial support for the child, who often endures
teasing, especially after beginning preschool.
5 to 9 Years:
- Team assessment at least every six months.
- Dentist and Orthodontist evaluation for dental/oral hygiene,
maxillary x-ray, braces, dental expansion, in preparation for
alveolar bone graft.
Nasoendoscopy to determine if intensive speech therapy is
needed or secondary surgery of the palate is needed.
9 to 12 Years:
- Alveolar Bone
- Dental/Orthodontic follow-up.
- Pharyngoplasty or pharyngeal flap per nasoendoscopy result.
- Ongoing health assessments.
12 to 17 Years:
- Nasal reconstruction, if recommended.
- Lip revision, if recommended.
- Ongoing assessment.
18 to 20 Years:
- Additional nose and lip revisions may be needed.
- Psychosocial support.
- Genetic counseling. People with cleft lip or palate have a
two to five percent of having one or more children with the
- Completion of any treatment not previously done.
- Coverage for cleft care ends at age 21. After that time, it
is considered "cosmetic" surgery and may not be covered by your
insurance. Please call your insurance company to determine
eligibility for services.