Continuum of Care

When your baby is born with cleft, the delivery room nurse usually calls the cleft palate program for initial evaluation.

Please see Newborn Nursery Consultation.

10 Weeks:

  • The first surgery, your child will have is the repair of cleft lip and rebuild muscles and tissues around his mouth and nose.
  • Your baby should be at least 10 pounds, and with no other medical problems that will put your baby at higher risk for post-surgical complications.
  • 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 physician)

6 to 10 Months:

  • Your child should have a hearing test on or before 6 months of age.
  • 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 issues.

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 therapy.
  • 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 Graft.
  • 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 condition.
  • Completion of any treatment not previously done.

21 Years:

  • 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.