How are cleft lip and cleft palate treated?
Children born with cleft conditions often face complex health issues. Experience shows that a multidisciplinary team of specialists best manages these issues. Learn more about our care team.
At Children's Colorado, treatments are determined on an individual basis and care starts with a visit to the Cleft Lip and Palate Program.
Typical timeline of procedures and care
Currently, there are no treatments available for unborn babies with cleft lip and cleft palate conditions, which is why surgeons repair clefts after birth. After your first visit, the team will develop a unique course of care with your family. Below, the timeline shows the typical timing of procedures and therapies included in treatment plans. Together, parents and the team at Children's Colorado will decide the best course of treatment.
Birth to 18 months old
1 to 3 months old
First visit to Cleft Lip and Palate Program
Nasoalveolar molding (NAM)
Occupational therapy/feeding evaluation
3 to 6 months old
Lip repair
Possible ear tubes; Ear tubes may be necessary more than one time; if placed, follow up with an ear, nose and throat specialist every six months
6 to 15 months old
Hearing test; complete a hearing test every year
Pediatric dentist; visit the dentist at 12 months and every six months after
15 to 18 months old
Palate repair
Possible ear tubes
Genetics evaluation
Speech therapy evaluation
Second visit to the Cleft Lip and Palate Program
2 to 5 years old
Speech therapy
Possible lip / nose revision surgery
Annual visits to the Cleft Lip and Palate Program
6 to 12 years old
Secondary speech surgeries
Alveolar bone graft
Annual visits to the Cleft Lip and Palate Program
8 to 18 years old
Kids attend Cleft Camp
Developmental screening, as needed
Annual visits to the Cleft Lip and Palate Program
13 to 18 years old
Orthognathic (jaw) surgery
Secondary speech surgeries
Dental and orthodontics
Septoplasty/rhinoplasty (nasal) surgery
Annual visits to the Cleft Lip and Palate Program
18+
Septoplasty/rhinoplasty (nasal) surgery
Genetics counseling; at reproductive maturity
Transition to adult care provider
Procedures performed at the Cleft Lip and Palate Program
Once the timeline and treatment plan are decided, treatments may include:
Nasal alveolar molding appliance (NAM) is a type of orthodontics used to treat infants with cleft lip and palate. A trained pediatric dentist makes the appliance specifically for an infant. Infants wear this daily until the primary cleft lip repair surgery. The appliance looks like a mouth retainer.
NAM is used to move the gum segments closer together. The process requires weekly doctor visits to monitor the movement of the gum and lip segments. At the end of the process, the nose is shaped to give it a more natural appearance.
Mandibular distraction osteogenesis (MDO) treats a condition known as micrognathia/retrognathia (a symptom of Pierre Robin Sequence), which means a small jaw. This condition can cause difficulties with breathing and feeding.
Mandibular distraction osteogenesis lengthens the jaw. By moving the jaw forward, the tongue and structures at the back of the throat move forward to open the airway. Opening the airway may help to relieve airway obstruction and improve feeding.
Tympanotomy surgery creates a small opening for placement of an ear tube. Approximately 90% of children with cleft palate will require tympanotomy and ear tube(s).
Additional cleft lip and palate surgeries include:
- Speech surgeries
- Cleft lip and/or palate revision(s)
- Nasal surgery
- Bone grafting
- Jaw surgery
Why choose Children's Colorado for cleft conditions?
For over 45 years, Children's Colorado has been a top treatment center in the country for children with cleft lip and palate. We are the largest program in the Rocky Mountain region, bringing together the benefits of comprehensive care, teaching and research.
At the Cleft Lip and Palate Program, we care for the whole child – inside and out. We offer additional activities and social outlets for patients with cleft conditions, including camps, bowling parties and holiday parties. We've found that these activities give children and teens the opportunity to spend time with others who share similar diagnoses and experiences, often resulting in new friendships and enhanced self-esteem.
The pediatric experts at Children's Colorado treat all aspects of cleft conditions. We have 11 pediatric specialties involved in establishing treatment plans for our patients. Our multidisciplinary team and exceptional outcomes have earned us the American Cleft Palate-Craniofacial Association endorsement.