Feeding a baby with a cleft lip or palate can be very different but we are here to help every step of the way. We will work with you to develop a care plan that is best for you and your child. 

With cleft lip and/or palate, the infant:

• Can't create a seal with the lip and tongue to latch onto the nipple.
• Can't push the tongue and nipple against the roof of the mouth to create suction.
• Can't move milk to swallow it.

We will provide recommendations for you and your child’s care and offer options for specialized bottles and nipples to help your baby feed with a cleft lip/palate. 

Surgery is performed for cleft lip repair and placement of hard palatal prosthesis. Sometimes ear tubes are also placed during this procedure. Surgery is usually about 3 hours, and your child will spend 1-2 nights in the hospital.

Surgery is done for soft palate repair and exchange of the hard palate prosthesis. Ear tubes may also be placed at this time. Surgery is usually about 2.5 hours, and your child will spend 1-2 nights in the hospital.

The hard palate prosthesis will be removed, this is usually done in a 30-minute outpatient procedure. About 3-4 weeks later, surgery is performed to do a hard palate repair and alveolar cleft repair with bone grafting (with cadaver bone and bone grafting protein). This surgery is about 3 hours long, and your child will spend 1-2 nights in the hospital.

Septorhinoplasty is performed to optimize the function of the nose, this is usually a 3 hour surgery with one night in the hospital.

We work to accomplish most of the necessary surgeries before your child is school-aged, and if surgeries are needed during this time we are able to plan to minimize school disruption. Depending on your child’s specific needs, they may need to plan on some of these procedures:

• 4-6 years old: Speech surgery (if needed), which is usually about a 2-3 hour procedure, with 1-2 nights in the hospital.
• 5-6 years old: Minor lip revisions (if needed), which is usually done in a 1 hour outpatient surgery.
• 5-6 years old: Tip rhinoplasty (if needed), which is usually done in a 1 hour outpatient surgery.
• 5-7 years old: Alveolar bone graft augmentation (if needed), which is usually about a 1-2 hour procedure, with 1-2 nights in the hospital.
• 9-15+ years old: Jaw surgery (if needed), which is usually a 3-4 hour surgery, with 3-4 nights in the hospital.

• Cleft lip and palate
  Cleft palate and cleft lip (with or without cleft palate) are the most common craniofacial conditions we treat. In these conditions, a baby’s lip and/or roof of the mouth (palate) don’t form properly during pregnancy. As a result, there is an opening (cleft) that may involve the lip, floor of the nose, gum line (alveolus), and palate.
• Robin sequence
  Also called Pierre Robin Sequence, this disorder presents with a very small lower jaw, cleft palate (opening in roof of the mouth) and possible difficulty breathing from the tongue position in the back of the mouth.
• Stickler syndrome
  A genetic disorder that affects the connective tissue of the body. Children with this syndrome will often have problems with vision, hearing, face and skeleton development and cleft palate (opening in the roof of the mouth).
• Van der Woude syndrome
  This syndrome is caused by a mutation in the IRF6 gene and is a common inherited form of cleft lip and/or palate (opening in the lip and/or the roof of the mouth). Children with Van der Woude Syndrome have lower lip pits (a mound of tissue with hole in center) and cleft lip, cleft palate or both.
• 22q11.2 deletion syndrome
  22q11.2 deletion syndrome, also known as DiGeorge syndrome, is a genetic disorder that affects how different parts of the body develop. People with this syndrome can have a variety of symptoms, even if they are in the same family. It can cause problems with the heart, immune system, mouth, and calcium levels in the blood.

• Ocular-Auricular-Vertebral spectrum (OAVS)
  A genetic disorder that involves changes or birth defects of the eyes, ears, and spine. Persons who have OAVS can have a mild presentation to a more involved presentation (called Goldenhar syndrome).
• Hemifacial microsomia
  This condition can range from mild to severe and causes half of the face to be underdeveloped and look different from the unaffected side. The ear and lower jaw are most commonly affected. Patients can have a mild presentation to a more involved presentation.
• Treacher Collins syndrome
  A genetic condition that mainly affects development of the face as well as causing defects of the eyes and ears. The cheek bones are underdeveloped and the lower jaw is very small. Patients may have a cleft palate (opening in the roof of the mouth). Patients can have a mild presentation to a more involved presentation.
• Nager syndrome
  A rare genetic condition that mainly affects the development of the face, ears, arms and hands. The cheek bones are underdeveloped and the lower jaw is very small. Many children will have a cleft palate (opening in the roof of the mouth).

• Apert syndrome
  A genetic disorder that affects how the bones of the skull and face are shaped and grow. These patients also have craniosynostosis which is the early closure of the sutures (seams) that separate the bones of the skull. The child will also have fusion of the digits of the hands and feet (syndactyly).
• Crouzon syndrome
  A genetic disorder that affects how the bones of the skull and face are shaped and grow. These patients also have craniosynostosis which is the early closure of the sutures (seams) that separate the bones of the skull.
• Pfeiffer syndrome
  In this syndrome, patients have abnormalities of the bones of the skull, face, hand and feet. These patients also have craniosynostosis which is the early closure of the sutures (seams) that separate the bones of the skull.