Cleft Lip and Cleft Palate in Children: Care Instructions

Overview

Cleft lip and cleft palate are fairly common birth defects that often occur together.

Cleft lip happens when the tissues of the upper jaw and nose don't join properly as a baby develops. This causes a split (cleft) in the lip. In most cases, a cleft lip does not cause feeding problems or other health problems.

Cleft palate happens when the roof of the mouth (palate) doesn't develop normally during pregnancy. This leaves an opening that may go through to the nasal cavity. It may affect any part of the palate, including the front part of the roof of the mouth (hard palate) or the small tag of tissue that hangs down from the soft palate (uvula). Some babies with cleft palates have problems sucking and swallowing, so feeding may be a challenge.

Both of these conditions are treated with surgery. Cleft lip is repaired in the first few months of a child's life; the timing depends on how bad it is. Cleft palate is usually fixed before 12 months of age. It often takes more than one surgery. Sometimes a cleft palate needs treatment before surgery. This may include special dental splints or soft dental molding inserts.

If a cleft lip occurs with a cleft palate, it is sometimes linked with another health condition. For this reason, it's important for children to be tested for other conditions starting at birth, especially if a baby has other symptoms. Some children with cleft lips may need other tests too, such as tests for speech and hearing problems.

If your child was born with a cleft lip or palate, it's common to have concerns and feel many emotions. You may wonder how others will react. Try to focus on bonding with your baby. Remember that these conditions can be treated. Most children who have them grow up to live normal lives.

How can you care for your child at home?

Caring for a child with a cleft lip

• Talk to your doctor if your baby has any feeding problems. Babies born with cleft lips often can breastfeed well. Bottle-feeding usually is not a problem if you use special nipples that are a different shape and have hole openings that are slightly bigger than normal.
• Take your child for all the testing your doctor recommends. Some children may need tests for other health conditions or for speech and hearing problems.

Caring for a child with a cleft palate

• If you have trouble feeding your baby, talk to your doctor. You may be able to breastfeed, but bottle-feeding usually works better than breastfeeding. Some people pump their breast milk and give it to their babies in bottles.
• Watch your baby for problems with choking, gagging, or milk coming out through the nose while feeding. You may be able to use a small plastic plate that fits into the roof of the baby's mouth while feeding. This blocks the opening so the baby can suck properly.
• Be alert for signs of dehydration. This can develop if your baby is not getting enough breast milk or formula. These signs include fewer wet diapers, sunken eyes with few tears, and a dry mouth with little or no spit.
• As your child grows, pay attention to:
  • Dental care. Be sure to take your child to a dentist regularly starting at age 1. A dentist will watch for dental problems and teach good dental habits. Check with your doctor about how to care for your baby's mouth before the first dental visit.
  • Hearing. Work with your doctor to test your baby's hearing by the time they're 3 months old, especially if they were not screened at birth.
• If you need more support, talk with your doctor or see a counselor. Also, you may want to join a support group. It may help to talk with other parents who have babies with a cleft lip or cleft palate.