Cleft Lip & Palate

What You Need to Know About Cleft Lip & Palate

Cleft lip and cleft palate are the most common surgical birth defects, occurring in 1 in 600 births nationally.

Both conditions develop in the first trimester of pregnancy, and the cause is often unknown.

  • Cleft lip is a condition where the two sides of the top lip do not fuse together during development, it also causes clefting of the nose leading to a wide abnormal nose that needs reconstruction.
  • Cleft palate is a condition where the roof of the mouth does not form completely, it also typically causes clefting of the gum (alveolus) and upper jaw (maxilla).

They can occur on one (unilateral) or both (bilateral) sides of the mouth and face. The lips and palate form separately as a baby develops, so a child can have one or both of the conditions. The size and position of the cleft is different in every child.

Both conditions are treatable, but they have the potential to cause:

  • Facial deformities
  • Dental problems-orthodontic needs
  • Feeding problems
  • Hearing impairment
  • Speech and language challenges
  • Sleep apnea

We know this diagnosis can be scary, but the SSM Health St. Louis Fetal Care Institute can help. We work hand in hand with the St. Louis Cleft-Craniofacial Center at SSM Health Cardinal Glennon Children’s Hospital to provide seamless care from prenatal diagnosis and delivery, to surgery and care through adulthood.

Cleft lip and cleft palate can be diagnosed via ultrasound as early as 16 weeks into a pregnancy. There are rare occurrences of mild cleft palate that are not diagnosed until after delivery when an infant has difficulty feeding.

During your pregnancy, we will help you and your family prepare for delivery and monitor the well-being of your baby. We will also perform a Level II ultrasound and a fetal echocardiogram to see if there are any other abnormalities. Depending on your unique situation, you may meet with members of our multidisciplinary team from:

This team will work with you to decide the best treatment for your child after delivery.

Each child is different and so is their palate form, this is why every child’s care plan is unique. Babies with cleft lip and cleft palate can typically go home after delivery, but will require surgery to repair the cleft during their first year of life.

Initially, your baby might have difficulty feeding; special cleft bottles, along with proper positioning, can help ease the feeding process. Our cleft-craniofacial team and lactation specialists have a wealth of knowledge and experience in feeding babies with cleft lip and palate, and can help you learn how to properly feed your baby.

After delivery, you and your baby will meet with the team from the Cardinal Glennon St. Louis Cleft-Craniofacial Center, who will help finalize a specialized care plan for your little one

The team at the Cleft-Craniofacial Center includes:

  • A Nurse Coordinator
  • Plastic Surgeons
  • Speech/Feeding Therapists
  • Audiologists
  • Ear, Nose, Throat Specialists
  • Orthodontists
  • Pediatric Dentists and Prosthodontists
  • Sleep Medicine Specialists
  • Genetic Specialists
  • Psychology Specialists

The team is designated an Affiliated Team by the American Cleft Palate-Craniofacial Association (ACPA), the governing association of cleft-craniofacial centers.

The treatment of cleft lip and cleft palate requires a collaborative approach involving a team of specialists. Proper treatment will help restore normal functions, create a more typical appearance and help the child reach his or her full potential.

Our plastic surgeons are specialists in cleft lip and palate surgery and can reshape the bones of the face to improve the normal shape and function of the face. During your child’s reconstruction, we can also repair the cartilage and soft tissues of the face, lips, palate, nose and tongue.

If your baby was born with a cleft lip we recommend lip repair surgery when your baby is between three and six months old. We typically repair a cleft palate when your child is 9 to 12 months of age. As your child continues to age and develop, additional surgeries might be required to enhance their function and appearance. You will learn more details about these surgeries during visits with the Cleft Team.

Working closely with you and your child, our goal is to restore the unique elements of your child’s appearance, so they can speak and function more normally, achieving their best life. Cleft lip and cleft palate can present a unique set of feeding challenges. A baby with a cleft palate typically has normal sucking and swallowing reflexes, but is unable to create negative pressure to efficiently suck or extract liquid from a bottle or breast. This is similar to when you try to drink from a straw with a crack in it. A baby with a cleft lip may have a hard time making a good seal around the nipple.

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