Cleft Lip & Palate

What is a Cleft Lip & Palate?

One out of every 700 newborn babies is affected by a cleft lip and palate, making it one of the most common birth defects in the United States. Cleft lip and palate refers to an abnormal separation of the lip and/or the roof of the mouth (palate). Multiple portions of the upper lip come together during development to form one piece during the sixth week of pregnancy. The development of the palate occurs later then the lip forming during the last part of the first trimester. Because the lip and palate develop at different times, it is possible for a child to be born with only a cleft lip, only a cleft palate, or with both a cleft of the lip and the palate.

A child with a cleft may undergo four to five operations spanning the years from infancy to young adulthood. These operations may include primary lip repair, primary palate repair, pharyngoplasty, alveolar bone grafting, orthognathic jaw surgery, and rhinoplasty.

Download a PDF file of the A Parent's Guide to the Repair of Cleft Lip and Palate.

Outlook & Treatment

It is important to understand that our team has a great deal of experience taking care of children like yours and the outlook for the future in terms of your child's appearance, function, and psychosocial well-being is excellent. Experience shows that surgical correction alone is not sufficient to ensure the overall physical and emotional well-being of children born with clefts and other craniofacial problems. Children may have a broad range of treatment needs, including:

Problems with feeding: Often a parent's first concern is, "How will I feed my baby with a cleft lip and palate?" For example, the cleft can make effective sucking difficult and the milk may come back through the baby's nose. However, your baby will thrive when you learn to feed effectively. A speech and feeding therapist can help you to find the right feeding method for you and your baby.. You will be taught ways to feed your baby, such as holding her in an upright position, giving small amounts of milk, and using a syringe or a nipple with a large hole. Feeding the newborn with cleft lip and palate
Problems with speech: Difficulties in speech may occur for many reasons. The development of hypernasal speech after a cleft palate repair is not uncommon. The quality of speech is often nasal and certain consonant sounds may be difficult for your baby to make because air may leak through the nose. Fortunately these speech difficulties can often be corrected with speech therapy alone. Therefore, your baby needs to be under close supervision of a speech and language therapist.
Problems with hearing: Your baby may have many more ear infections than a baby without a cleft. Difficulties in swallowing affect air pressure in the middle ear and spread infection through the nose to the ears. An audiologist and an ear, nose, and throat specialist will need to monitor your child's hearing closely because frequent ear infections that could lead to hearing loss.

Scheduling an Initial Consultation

You may contact the University of Michigan's Craniofacial Anomalies Clinic directly at (734) 764-2582. Your child's pediatrician can also assist you in providing a referral as well as the medical information you will need to provide during the initial consultation.

List of Physicians Who Perform Cleft Lip & Palate Surgery

For details about education, experience, and specialty in this clinical area, please visit these physician profile pages:

What to Expect at the Initial Consultation

Because of the complexity of these types of conditions, you should plan for your child's initial consultation to last anywhere from 2-3 hours from check-in to completion. Remember to bring along toys, books, and a snack for your child.

During the initial consultation, you should anticipate meeting with at least one, and probably several physicians, and you should expect:

To provide a complete medical history, including information about previous surgical procedures; past and present medical conditions; and any medications your child is taking.
To provide copies of your child's medical records, including x-rays.
The doctor to conduct a complete physical examination and provide a diagnosis.
To discuss with your doctor the treatment options recommended for your baby and to establish a treatment plan.

Subsequent follow-up by the Cleft Lip & Palate Team is necessary starting at two-and-a-half years of age. Your child's growth and development will be followed by the specialists on the team to develop a treatment plan and perform necessary diagnostic studies, surgical procedures, and other treatment modalities. Your child should be seen every 1-2 years.

Resources for Families

Wide Smiles: A quarterly magazine for families of children born with cleft or other craniofacial deformity. The magazine provides useful information, inspiration and support. For more information, call (209) 942-8212.
Early On: Early intervention services for infants and toddlers are available across Michigan. For more information about evaluations and services, call your local intermediate school district or Project Find at (800) 252-0052.
American Cleft Palate Craniofacial Association: A professional organization that includes 27 different disciplines. It offers conferences, medical journals, booklets and CLEFTLINE for parents of newborns, (800)-24-CLEFT. Web Address: http://www.cleftline.org/
About Face: An international information and support organization for people with facial difference and their families. Resources include a bi-monthly newsletter, parent support training, books, videos, and a lending library. For more information, contact Pam Onyz at (800)-225-FACE.
Children's Craniofacial Association: A non-profit organization dedicated to providing and supporting a network to meet the medical, financial, and emotional needs of craniofacial patients and their families. For more information, call (800) 535-3643.
Family Support Network of Michigan: A network of parents who have children with special needs. The network offers peer support and information on Children's Special Health Care Services. For more information, contact the Parent Hotline at (800) 359-3722.
MUMS: A national parent-to-parent organization for parents or care providers of a child with any disability, disorder, chromosomal abnormalities, or health condition. MUMS provides support by matching parents with other parents whose children have the same condition. For information, call (414) 336-5333.