Cleft Lip and Cleft Palate

The underlying cause of cleft lift is still widely unknown. It is important that you, as the parent, don’t feel like you are to blame for the anomaly. While it is suggested these conditions could be genetic, it is still very much a mystery. There is a greater chance of having a child with a cleft lip if a parent or sibling has one. Most children affected with cleft lips develop their facial difference without a known or direct link to exposures during or after pregnancy. A few exceptions that are associated with the development of cleft lip include:

• Smoking while pregnant leads to a twofold increase in the risk of developing a cleft lip.
• Taking Phenytoin (Dilantin) during pregnancy makes cleft lip 10 times more likely to occur.
• Using alcohol, anti-seizure medicines or Vitamin A (retinoic acid) is linked with birth defects, including cleft lip.

Diagnosis is often discovered at birth but can also sometimes be detected by prenatal ultrasound. If a cleft lip has been discovered via an ultrasound during pregnancy, we understand you will want answers as soon as possible. Our specialized team is ready to provide you guidance and can even connect with you and your family prior to your child's birth to create a plan of care once your baby arrives.

If a cleft lip is discovered after birth, expertly trained craniofacial plastic surgeons should conduct a thorough diagnosis through a multidisciplinary team evaluation. Once a diagnosis is presented, we can guide you through the treatment process and what the best care plan would be for your child.

At AdventHealth for Children, cleft lip repair is typically performed between 3-6 months of age. It may require pre-surgical orthodontic treatments (nasoalveolar molding or Latham appliance) along with one or two surgeries depending on the extent of the malformation and patient-specific considerations. Also referred to as NAM, nasoalveolar molding is a nonsurgical way to reshape the gums, lip and nostrils with a plastic plate before surgery. A Latham appliance is a device that is utilized to help decrease the width of the cleft prior to surgery.

If two surgeries are determined to be necessary, the first surgery may be performed at 2-2.5 months of age followed by a definitive cleft lip repair around 5-6 months of age.

Our dedicated Cleft and Craniofacial Nurse Care Coordinator will guide you through each step of your child’s treatment, including surgery, so you always feel supported.

A cleft palate is a facial and oral malformation that happens very early in pregnancy while your baby is still developing. Although the exact underlying causes are still widely unknown, approximately 20-50% of babies born with cleft palates may have a syndromic association. There are hundreds of named syndromes that may be associated with cleft palate.

Most of the time, a cleft palate is diagnosed after a baby is born. However, there may be times that a cleft palate can be seen on a prenatal ultrasound while the mother is still pregnant. In these cases, you can prepare with the knowledge of future treatments for your baby once they are born and even meet with our Cleft and Craniofacial team for a consultation so that you can feel confident and ready when the time for cleft palate care arrives.

Cleft palate repair is performed between 10 and 12 months of age and is a bit more complex than cleft lip repair. It may require multiple surgeries over the course of the child’s childhood, up to 18 years of age. This can include a bone graft on the upper gum line at around 8 years of age to support the growth of permanent teeth. Our care team will help guide your family throughout the process and help you navigate care and treatment.