This is a timeline for treatment of the child with a cleft palate. This timeline provides you with a general treatment plan overview. Each child with a cleft palate is unique and will have their own treatment plan.
Your baby will see a plastic surgeon in their first month.
What to expect at this visit:
The team will:
- Ask questions about your family history and your pregnancy
- Weigh your baby
- Take photos of your baby
- Review the best treatment plan for your baby
If your baby needs a special appliance to help them eat, they will also need to see a pediatric dentist.
What to expect at this visit:
- The dentist will make a model of your baby’s gumline to create a dentomaxillary appliance (this looks like a retainer)
Between 6 weeks to 2 months of age, surgery is done to insert the appliance in their mouth
- Surgery is done with general anesthesia (sleepy medicine) and your baby stays overnight in the hospital
- It is time to get your baby ready for their cleft palate repair.
- Teach them to drink from a regular cup – not a sippy cup.
- When the cleft palate is repaired, your child will have stitches in the roof of their mouth. Using a sippy cup or pacifier (or anything that makes them use a sucking motion) can irritate the stitches.
- The cleft palate is repaired.
- If your baby hasn’t had ear (PE) tubes placed, they are inserted during this surgery
- If your baby needs further repair of a cleft lip, it is also done at this time.
- Your baby will stay one to two nights in the hospital and need to wear arm restraints to keep them from putting anything in their mouth.
- Your baby will go home when they are able to drink enough fluids.
3-5 Years Old
- When your child begins to speak in sentences, a speech pathologist will evaluate their speech. Speech therapy and/or surgery may be needed.
- If surgery is needed, your child will see a plastic surgeon that will perform pharyngeal flap surgery.
- Your child will usually stay in the hospital two to four days after surgery until they are drinking well.
5-9 Years Old
- If your child has a cleft through the gumline they may need to have this area expanded in preparation for a bone graft.
- The pediatric dentist or orthodontist does this in the office. It is like getting braces.
- The bone graft is done in the hospital and bone is taken from the hip for this graft.
- Typically your child stays overnight in the hospital.
11-20 Years Old
- Braces (orthodontics) are usually started around this age.
- As your child’s face changes, other revisions of the lip and/or nose may be desired.
- For some of the procedures it is necessary to wait until your child is finished growing.
- Jaw surgery to bring the upper jaw forward and/or the lower jaw back
- Septorhinoplasty – to straighten and refine the nose
- Malar implants – to build up the mid-face (cheekbones), revision of the lip and nose
- The plastic surgeon will discuss these options with you.
- The length of hospital stay depends on the type of surgery performed.