Treatments for cleft lip and palate require a multidisciplinary approach because of the many complications associated with the problem. Medical teams combine the skills of specialists in cleft lip and palate, including:
- Pediatrician to coordinate the multiple specialties
- Genetic counselor to assist in diagnosis and counsels families on the potential for clefts in future pregnancies
- Nurse team coordinator experienced in pediatric care who acts a liaison between Pediatric dentist who cares for the child’s teeth
- Otolaryngologist (ear, nose and throat specialist) to treat ear infections
- Plastic/craniofacial surgeon to correct the cleft
- Orthodontist who will manage realignment of teeth
- Audiologist to evaluate and manage hearing problems
- Speech and language therapist to monitor and assist in speech development the cleft team and the family
- Social worker who assists with the emotional and social aspects and provides referrals to community support programs
Surgery to close a cleft lip is usually performed when the baby grows to 10 to 12 pounds and can tolerate the procedure better. One treatment option is for the doctor to close the cleft with a temporary prosthesis allowing the baby to nurse and grow. A cleft lip usually is repaired between the ages of six weeks and nine months. Surgery for a cleft palate is commonly done between ages six and18 months, so that speech can develop normally. Depending on the severity of the deformity, follow-up procedures may be needed.
Following surgery for a cleft lip, the child is likely to be irritable. Pain should be mild and may be relieved with medications as directed by the doctor. Swelling, bruises and some blood on the lips are normal. An intravenous catheter may be needed until the child can drink by mouth. The more involved cleft palate surgery causes more discomfort and may require a hospital stay of two or three days. In addition, the child may experience nasal congestion that can be relieved with medication.