If your child has recently received a diagnosis of a cleft lip or cleft palate, this article will address your most pressing questions, including:
What happens when a cleft lip and palate are seen during a prenatal ultrasound?
What happens when a cleft lip or palate is discovered in a newborn?
Are there cleft lip and cleft palate treatment options without surgery?
What should I expect from a cleft lip operation?
What should I expect from a cleft palate surgery?
What speech and communication challenges follow a cleft lip and cleft palate surgery?
What cognitive complications can follow cleft surgery?
What happens when a cleft lip and cleft palate are seen during a prenatal ultrasound?
A 20-week prenatal ultrasound often shows if a cleft lip is present. If a cleft lip is discovered, a doctor may conduct the following tests:
A 3D ultrasound may be used to find out the type of cleft.
An MRI may be used to try to see if there is a cleft palate.
High-resolution ultrasound and fetal MRI may detect brain malformations that can also occur in less than 10% of cleft lip and palate cases.
An amniocentesis may be used to remove amniotic fluid from the amniotic sac to check for other congenital disorders.
Once a cleft lip or palate is identified, the parents can work with a care team to understand what to expect at birth. See Symptoms and Early Signs to learn more about that care team.
What happens when a cleft lip or cleft palate is discovered in a newborn?
If a cleft lip or palate is discovered in the newborn oral exam, the doctor will perform a comprehensive exam to identify the type of cleft. From there, a care team will be formed.
To learn about the types of cleft lip and palates, see Seven Quick Facts You Should Know.
To learn about the care team, see Symptoms and Early Signs.
Are there cleft lip and cleft palate treatment options without surgery?
In most cases, cleft lip treatment and cleft palate treatment will require at least one surgery.
What should I expect from a cleft lip operation?
Cleft lip surgery usually occurs when a baby is about three months old. The cheiloplasty surgery will close the cleft and improve the shape of the upper lip and nose. The cleft surgery often leaves a small scar under the nose.
Sometimes, a child needs additional surgeries to fix:
The shape of the lip
The shape of the nose
The function of the nose.
If the child has both cleft lip and cleft palate, a combination of cleft lip and palate surgery will be necessary.
What should I expect from a cleft palate surgery?
A cleft palate operation, called palatoplasty, usually occurs when a baby is 10–12 months old. Palatoplasty is designed to close the opening between the nose and mouth and create a palate that works well for speech, eating, and drinking.
Fixing the cleft palate may require additional surgeries, which may include:
About 25% of people with cleft lip and palate require a palatal expansion surgery between the ages of 5 and 7 if the palate collapses.
Alveolar bone graft and fistula repair may be necessary between the ages of 6 and 9 years to make space for permanent teeth.
Tip rhinoplasty may be performed between the ages of 6 and 9 if there is a deformity in the nose.
Orthodontic care may be performed in two phases: between the ages of 6 and 9 and again between the ages of 14 and 18.
If the upper jaw is not correctly formed, orthognathic surgery may be performed between the ages of 14 and 18.
Finally, as people with a cleft lip or palate enter adulthood, they may choose to have plastic surgeries or nonsurgical procedures to define their facial features better.
What speech and communication challenges follow a cleft lip and cleft palate surgery?
After cleft lip and palate surgery, about 20% of children with clefts have speech problems. A speech-language pathologist (SLP) will usually make two assessments to look at how well the child understands words and how they sound when they speak. The first is around 18-24 months old, and the second is when the child is around three years old.
To understand the long-term effects of clefts on language, speech, and communication, see Planning for Long-term Care.
What cognitive complications can follow cleft surgery?
Some research indicates that children born with cleft lip and palate have cognitive difficulties as they get older.
Cognitive impacts may include:
Lower than average general IQ.
Reading and memory deficits are similar to those found in children with developmental dyslexia and developmental dysphasia.
Reading disabilities occur 6 to 10 times more often than in children without cleft lip and cleft palate.
Where can I find more information about cleft lip and cleft palate?
Ability Central offers a series of articles to further your knowledge about cleft lip and palate. See:
To connect with a non-profit specializing in cleft lip and palate care, see Ability Central’s searchable database of service providers.
Additional Information
The content provided in this article is for informational purposes only and is not intended as a substitute for legal, medical, or other professional advice. While we strive to provide accurate and up-to-date resources, some information may become outdated or incomplete. Always consult with your provider about personal medical concerns.
