What Position Is Best To Put A Baby After A Right Cleft Lip Repair?

Children with a cleft lip or palate will need several treatments and assessments as they grow up.

A scissure is usually treated with surgery. Other treatments, such equally voice communication therapy and dental intendance, may likewise be needed.

Your child will be cared for past a specialist fissure team at an NHS crevice centre.

Your child'south intendance plan

Children with clefts will have a intendance plan tailored to meet their private needs. A typical intendance plan timetable for cleft lip and palate is:

birth to six weeks – feeding assistance, back up for parents, hearing tests and paediatric assessment
3 to 6 months – surgery to repair a cleft lip
6 to 12 months – surgery to repair a crack palate
18 months – speech communication assessment
three years – speech assessment
5 years – oral communication assessment
8 to 12 years – os graft to repair a cleft in the mucilage area
12 to xv years – orthodontic handling and monitoring jaw growth

Your child will also need to nourish regular outpatient appointments at a cleft eye so their condition tin be monitored closely and any problems can be dealt with.

These volition usually be recommended until they're around 21 years of historic period, when they're likely to have stopped growing.

Surgery

Lip repair surgery

Lip repair surgery is usually done when your babe is around 3 months onetime.

Your baby will be given a full general anaesthetic (where they're unconscious) and the cleft lip will be repaired and closed with stitches.

The operation ordinarily takes 1 to 2 hours.

Nigh babies are in infirmary for 1 to 2 days. Arrangements may be made for you lot to stay with them during this fourth dimension.

The stitches will be removed after a few days, or may deliquesce on their own.

Your child will have a slight scar, simply the surgeon volition try to line up the scar with the natural lines of the lip, to make information technology less noticeable. It should fade and become less obvious over time.

Palate repair surgery

Palate repair surgery is normally washed when your baby is 6 to 12 months old.

The gap in the roof of the mouth is closed and the muscles and the lining of the palate are rearranged. The wound is closed with dissolvable stitches.

The functioning usually takes almost 2 hours and is washed using a full general anaesthetic. Most children are in hospital for i to 3 days, and over again arrangements may exist made for y'all to stay with them.

The scar from palate repair will exist inside the mouth.

Additional surgery

In some cases, additional surgery may be needed at a later on stage to:

repair a fissure in the gum using a piece of bone (a bone graft) – usually done at around 8 to 12 years of age
improve the appearance and role of the lips and palate – this may be necessary if the original surgery did not heal well or there are ongoing speech bug
improve the shape of the nose (rhinoplasty)
improve the appearance of the jaw – some children born with a fissure lip or palate may have a pocket-size or "set-back" lower jaw

Feeding help and advice

Many babies with a cleft palate take problems breastfeeding considering of the gap in the roof of their oral cavity.

They may struggle to form a seal with their mouth – so they may accept in a lot of air and milk may come out of their nose. They may as well struggle to put on weight during their commencement few months.

A specialist cleft nurse tin can suggest on positioning, culling feeding methods and weaning if necessary.

If breastfeeding is non possible, they may suggest expressing your breast milk into a flexible bottle that is designed for babies with a crack palate.

Very occasionally, it may exist necessary for your infant to be fed through a tube placed into their nose until surgery is carried out.

Treating hearing problems

Children with a cleft palate are more likely to develop a condition called gum ear, where fluid builds upward in the ear.

This is because the muscles in the palate are connected to the centre ear. If the muscles are non working properly because of the cleft, sticky secretions may build upward within the center ear and may reduce hearing.

Your child will take regular hearing tests to check for any issues.

Hearing problems may improve after scissure palate repair and, if necessary, can be treated by inserting tiny plastic tubes called grommets into the eardrums. These allow the fluid to drain from the ear.

Sometimes, hearing aids may be recommended.

Dental care

If a cleft involves the gum area, information technology'due south common for teeth on either side of the cleft to be tilted or out of position. Often a tooth may exist missing, or at that place may be an extra tooth.

A paediatric dentist will monitor the health of your child's teeth and recommend handling when necessary. It's also important that you annals your child with a family dentist.

Orthodontic treatment, which helps meliorate the alignment and appearance of teeth, may besides be required. This can include braces or other dental appliances to assist straighten the teeth.

Brace treatment usually starts afterwards all the infant teeth have been lost, but may be necessary earlier a bone graft to repair the scissure in the gum.

Children with a fissure are more than vulnerable to tooth disuse, then it'southward of import to encourage them to practise good oral hygiene and to visit their dentist regularly.

Speech and language therapy

Repairing a cleft palate will significantly reduce the chance of speech problems, but in some cases, children with a repaired cleft palate still need speech therapy.

A speech and linguistic communication therapist (SLT) will assess of your child'southward spoken language several times equally they go older.

If there are any problems, they may recommend further assessment of how the palate is working and/or work with y'all to help your child develop clear speech. They may refer y'all to community SLT services near your dwelling house.

The SLT will continue to monitor your child'southward speech until they are fully grown and they will work with your child for as long as they need assistance.

Farther corrective surgery may sometimes exist required for a modest number of children who have increased airflow through their nose when they're speaking, resulting in nasal-sounding speech.

Specialist UK cleft lip and palate centres

England

Royal Victoria Infirmary, Newcastle-upon-Tyne
Leeds General Infirmary
Royal Manchester Children'southward Hospital
Alder Hey Children's Hospital, Liverpool
Nottingham Children'due south Hospital
Birmingham Children's Infirmary
Addenbrooke's Hospital, Cambridge
Corking Ormond Street Hospital, London
Broomfield Hospital, Chelmsford
John Radcliffe Hospital, Oxford
Salisbury District Hospital
Bristol Purple Infirmary for Children
Guy's and St Thomas' Hospital, London

Wales

Morriston Hospital, Swansea

Scotland

Royal Infirmary for Sick Children, Edinburgh
Majestic Hospital for Ill Children, Glasgow

Northern Ireland

Children's Hospital, Belfast

Folio last reviewed: 13 August 2022
Next review due: 13 Baronial 2022