Cleft lip and cleft palates occur in approximately 1:700 -
1:1,000 live births. Cleft lips are frequently diagnosed on
ultrasound scanning. Sometimes a cleft palate can be detected this
way. Most frequently an isolated cleft palate is detected at
When can patients with cleft lip and palate be
The four main cleft lip and palate centres are Auckland, Hamilton,
Wellington and Christchurch. There may be outreach clinics from
these centres. Parents and children are generally seen at the time
Can cleft babies breast feed?
Most babies with an isolated cleft clip are able to breast feed.
Babies with a partial cleft palate also can often breast feed.
Babies with wide cleft palates are usually not able to breast feed.
Help with feeding will be given from speech therapists and
lactation consultations. Some babies can feed with a combination of
breast and bottle. There are special teats available to help
babies, eg Habermam and pigeon teat.
Cleft lip and palate surgery is usually staged. Children with
cleft lip and palate are usually followed up until the age of 18 in
the multi-disciplinary team.
Unilateral cleft lip repair
Unilateral cleft lip repair is generally performed when the baby
is 3-4 months old. Surgery takes approximately 2 hours. The
hospital stay is generally 2-3 days. During this procedure the lip
is repaired and the nose reshaped.
Bilateral cleft lip repair (two sided)
Bilateral cleft lips are also usually repaired at 3-4 months
with 2-3 days in hospital.
Cleft palate repair
In most cases the cleft palate repair is performed at 9-12
months. Surgery generally lasts 2 hours. The local tissue of the
palate is rearranged to close the gap and the speech muscles are
restored to their proper place. Most children are in hospital for
3-5 days following surgery.
Will my child need grommets?
Children with cleft palate have a much higher chance of having glue
ear. An ear nose and throat specialist will make an assessment to
determine whether grommets would be helpful at the time of cleft
Children with cleft lip and palate are followed regularly by the
multi-disciplinary cleft team. Cleft lip and palate teams consist
of a plastic surgeon, a maxillofacial surgeon, orthodontist, speech
therapists and also in some cases a paediatric dentist and ear nose
and throat specialist. Speech will be closely monitored as the
child develops. Most children develop normal or near-normal speech
after surgery, however some may require further surgery to improve
Orthodontics and bone grafting
At the age of approximate 8 years old children who have had
repaired cleft of the front of the palate will require orthodontics
to ready the adult teeth for bone grafting of the gap in the gum
line (or alveolus). Bone is generally taken from the hip in an
operation lasting 1½ hours. This is packed into the gap in
readiness for the canine tooth to drop into this space. Further
orthodontics will then be required.
At the age of 16-18 jaw surgery to bring the upper jaw forward
is sometimes required. Reshaping of the nose (or rhinoplasty) is
usually the last procedure that may be required at this age.
Cleft Lip and Palate Support Group www.cleft.org.nz
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