Cleft Palate & Cleft Lip
No one wants to be told that their newborn needs surgery. Unfortunately, it can’t always be avoided. Cleft lip and cleft palate surgery is one of those times.
Sometimes, a birth defect affects the way a child’s mouth forms, causing an oral-facial cleft. This causes a gap, just beneath the nose. When this gap occurs in just the lip it’s referred to as a “cleft lip." When it occurs in the roof of the mouth it’s called a “cleft palate.”
Most of the time, a cleft lip and palate occur together, but not always.
Cleft Lip and Cleft Palate Surgery at UVA Health Children's
The team at UVA Health Children’s is certified by the American Cleft Palate Craniofacial Association. Our specialists are dedicated to providing complete care to children born with this condition.
An important facet of our care standards is having a multidisciplinary approach. What that means for you is that all of the providers needed to treat your child’s condition will be involved at your child's appointments.
Having one appointment offers convenience to parents. More importantly, it means that the answers you need can be provided, and the team can work cohesively. This results in better outcomes, and allows for families to have input in their child’s plan of treatment.
Complete Cleft Palate Care
The American Cleft Palate Association certified team at UVA Children’s Hospital is dedicated to providing complete care for children with cleft palates.
JARED CHRISTOPHEL: The UVA cleft lip and palate team has a lot of experience and a lot of expertise across our various specialties to treat your child with cleft lip and palate.
ALEXIS FEYERHERD: We strive to give complete care. We have a multidisciplinary clinic where our patients are able to see every specialty that they meet pertaining to their cleft and they can get everybody's recommendations all at one appointment which is great for convenience but it's also great for our providers to be able to be sure that we're not missing anything, that we're treating the whole patient.
THOMAS GAMPPER: The philosophy of the team is putting the patient first. So it's a very stressful situation oftentimes for parents. They have a newborn that has a condition that they don't fully understand. We want to treat both the patient and the family to make sure that it's an easy time for them and make it is as easy as possible.
JONATHAN BLACK: I find it very rewarding because the impact that I have is immediately visible even after an hour or two of surgery and it's a challenge that you have to deal with throughout their entire growth period. It motivates me and it allows me to be a part of their life throughout their growth.
KATHLEEN BOROWITZ: I think that our team does work very much hand-in-hand. I think one of the things families like when they come to our clinic is that we are sharing information between ourselves right in front of them we want them to know what we're thinking and then we explain it to them and ask for their input on it. But I think they feel very much that we are telling them everything that's going on, that they hear the discussions themselves.
WILLIAM HORBALY: Most of these children we will follow from infancy all the way through their adolescent and late teenage years. I see them usually at a young age assessing their dental health and then end up providing orthodontic care usually when they're adolescents.
JARED CHRISTOPHEL: UVA is one of the few cleft teams that is certified by the American Cleft Palate Association in the state and that is a rigorous certification process because clefting should be taken care of in a multidisciplinary fashion.
ALEXIS FEYERHERD: We have really built this team with so many specialties and so many layers of expertise and experience and new ideas and the research and just the minds that are involved are unparalleled.
Who’s On Your Child’s Team?
Your child's care team will be comprised of specialists from a variety of disciplines. This ensures we're ready to address a variety of concerns. Some of the team you may meet includes:
Cleft Palate Treatment Time Frame
From birth, we’ll be there to help you address early issues with feeding and speech development. Surgery for a cleft lip can be performed as early as 3-4 months of age and a cleft palate can be fixed at a year old. These surgeries will aim to close the gap in the lip and palate.
Eventually your child may also need surgery to improve the appearance and function of their mouth or to correct bite alignment.
After surgery, we’ll continue to provide follow-up care for your child, and alter their individualized care plan as needed.
What Causes a Cleft?
Early in pregnancy, all babies have an opening in the lip and palate. As the baby grows, these openings should gradually grow together and close by birth. In children with oral-facial clefts, these openings fail to close. The exact cause is unknown, though we know that genetics plays a key role.
While we don't know what causes an oral-facial cleft, we do know that getting prenatal care and taking 400 mg of folic acid a day reduces the chances.
Often, a prenatal ultrasound can show a cleft lip or palate. Being prepared and having a treatment plan offers peace of mind.
Cleft Complications
Oral-Facial Clefts need to be treated to prevent potential complications. Some of the complications include:
- Feeding problems, especially for a child with cleft palate
- Problems with speech development
- Dental problems, including missing teeth, especially when cleft lip extends to the upper gum area
- Symptoms of middle ear infections
- Hearing problems
- Symptoms of sleep-disordered breathing