In life-threatening emergencies, find the emergency room location nearest you. For non-life-threatening medical needs when your pediatrician is unavailable, visit one of our urgent care locations.
For the latest cutting-edge research, innovative collaborations and remarkable discoveries in child health, read stories from across all our areas of study in Q: Advances and Answers in Pediatric Health.
We use cookies to provide you with the best online experience. If you continue browsing, it means that you accept and agree to our Terms of Use & Privacy Policy
We collaborate with every specialty in the hospital to advance new surgical techniques, teach tomorrow’s surgeons and give our patients a brighter today.
A cleft lip or palate diagnosis can seem overwhelming at first. Over the years, the condition has been very well documented, and doctors and surgeons have made great strides in the care they can provide. Treatment options have expanded, and the overall quality of treatment has greatly improved.
We provide resources, services and information on organizations that can help you and your family learn more about cleft lip and cleft palate and understand and manage the condition better.
Photographs of our patients before and after cleft lip and/or cleft palate surgery
Cleft lip or cleft palate are conditions that can require several surgeries to repair. For many parents and families, it’s hard to visualize what the final result might look like. These before and after pictures show children that our surgeons have performed cleft lip and/or cleft palate repair on. Each diagnosis is unique, and results may vary, but these photos represent some of the repairs our surgeons can perform.
Support for parents and families
Support groups can be very helpful for getting advice on the challenges you or your child with cleft lip or cleft palate might face. It can be especially helpful to speak with someone who can share their experiences and pass on what they have learned.
Face-to-Face Colorado knows that the best resource for families affected by cleft conditions is other families. Their events and programs are developed by individuals with clefts, their family and friends. Face-to-Face is dedicated to ensuring that all services are open and welcoming to everyone.
Peak Parenting Center is a Colorado Springs-based organization that helps parents advocate for their kids in school.
Children’s Craniofacial Association is a non-profit organization based in Dallas that provides educational information regarding craniofacial conditions and networking support for families.
About Face is a Canadian organization that provides resources and educational programs as well as emotional, peer and social support to individuals of all ages with facial differences and their families. They seek to increase public understanding and acceptance of people living with facial differences through public awareness.
Families U.S.A. is a national nonprofit, nonpartisan organization dedicated to the high-quality, affordable health care for all Americans. The website includes information on federal managed care legislation and a state-by-state guide to managed care issues and policies. Check their extensive page of links for a list of other advocacy organizations.
Family Voices is a national grassroots organization comprised of families and professionals who care for children with special health care needs. The website provides information on the Children's Health Insurance Program (CHIP), managed care, SSI benefits, Medicaid and a brief summary of activities in each state.
The mission of the Patient Advocate Foundation is to educate patients about managed care, public policy issues that may affect coverage and how to clarify the terms of an insurance policy. The organization also provides legal intervention services. The website presents information in English and Spanish.
SNAP Medical Insurance Empowerment Program advisors work with parents on creative ways to approach insurance companies for authorizations or reimbursements regarding medical care for children with special healthcare needs. Families must have private insurance and fees are charged on a sliding scale basis.
Suggested reading
Cleft lip and cleft palate are well-documented conditions and there is a lot of helpful literature available for children and families. Some of our recommendations include:
“A Parent's Guide to Cleft Lip and Palate,” by Karlind Moller, Clark Starr and Sylvia Johnson.
“As You Get Older: Information for Teens Born with Cleft Lip and Palate,” by Cleft Palate Foundation.
“Children with Facial Difference: A Parent's Guide,” by Hope Charkins.
“Cleft Talk for Kids,” by Melissa Johnston-Burnham; an interactive, child-friendly book explaining cleft lip and cleft palate conditions.
“The Body Image Workbook,” by Thomas F. Cash; helps kids fight negative body images and create a healthier relationship with themselves.
“Your Cleft-Affected Child: The Complete Book of Information, Resources, and Hope,” by Carrie Gruman-Trinkner and Blaise Winter.
"Wonder,” by R.J. Palacio; born with a facial deformity that initially prevented his attendance at public school, August "Auggie" Pullman enters the fifth grade at Beecher Prep and struggles with the dynamics of being both new and different in this tale about acceptance, self-esteem and the transformative power of human kindness. Available in English and Spanish.
“We Are All Wonders” by R. J. Palacio; parents and educators can introduce the importance of choosing kindness to younger readers with this gorgeous picture book, featuring Auggie and Daisy on an original adventure. Available in English and Spanish.
Babies born with a cleft lip and/or palate may have a harder time feeding than normal. The team in the Children's Hospital Colorado Cleft Lip and Palate Program is here to teach parents how to feed their baby with a cleft, discuss any concerns and answer any questions.
What to know about breastfeeding and bottles for cleft lip/palate:
Babies with a cleft may have a weak suck or may have a hard time creating enough suction to breastfeed or get milk/formula from a regular bottle.
A baby with just a cleft lip may be able to feed normally or with a little help depending on the size of the cleft. However, some usually need a special feeding system for successful feeding.
A feeding specialist can help choose the best feeding system and best methods to ensure the baby attains a safe and successful feeding.
Babies with a cleft palate may have liquid or food go into and come out of their nose during and after feeding. This is due to the area of the palate that is open between the nose and mouth.
It is recommended that babies with a cleft lip and/or palate complete their full feeding in 20-30 minutes to allow for maximum caloric intake. Babies should gain 20-30 grams of body weight a day for adequate growth.
What does a baby with a cleft lip and/or cleft palate eat?
Babies with a cleft lip and/or cleft palate can be fed pumped breastmilk, formula or a mixture of both. Your primary healthcare provider can help you choose the best option for your baby.
Babies with a cleft lip and/or cleft palate usually start spoon feeding with solids at the same time as babies who don’t have a cleft. Our cleft team, along with your primary healthcare provider, will help you decide when to start giving your baby solids.
What bottles are best to feed babies with cleft lip and/or cleft palate?
A cleft lip and/or cleft palate can make it hard for a baby to feed with a regular bottle system that you buy at the store. The cleft team at Children’s Colorado may suggest one of several bottles available specifically for babies with a cleft lip and/or cleft palate.
The Medela Special Needs® Feeder (formerly called the Haberman Feeder) is made for babies with special feeding needs, including babies with facial differences. The nipple has flow rate lines that let you adjust the milk flow to suit your baby’s feeding needs, along with a one-way valve that keeps milk in the nipple. This system is available in different bottle and nipple sizes.
The Dr. Brown’s Specialty Feeding System®includes a bottle and nipple with a special valve called the Infant-Paced Feeding Valve. This system assists with establishing flow when the baby sucks.
When does your baby need supplemental nutrition?
It’s important that all babies get enough nutrition for growth and development. Medical professionals will decide when this type of feeding is necessary, such as:
Some babies need to have the calories of their formula or breast milk increased. When this is necessary, we follow a very specific recipe.
Some babies need nasogastric tube (NG tube) This tube may provide supplemental feeding or feeding support for a short period of time when a baby is having a hard time taking their full feedings with a bottle.
Some babies need gastrostomy tube (G-tube) This tube is usually recommended when a baby needs supplemental feedings for a longer period of time or when babies have a lot of trouble with feeding.
Helpful tips when feeding a baby with a cleft lip and/or cleft palate:
Use a bottle specially made for babies with a cleft lip and/or cleft palate.
Hold your baby in an upright, cradled position with your baby’s head well-supported.
If there’s a cleft of the lip, try to close the gap as much as possible with the nipple of the bottle or with the breast tissue if breastfeeding.
If your baby needs extra help getting milk, you can gently squeeze the bottle or the nipple (depending on the feeding system being used) in a pulse-squeeze pattern. If you give your baby extra help, it’s important to time squeezing the bottle/nipple with the baby’s sucking activity and to closely watch your baby’s cues for signs that the milk is flowing too fast.
Try to keep feedings under 30 minutes, including time for burping. If feedings last longer than 30 minutes, your baby may be working too hard and burning too many calories.
Your baby may need to be burped every ½ to 1 ounce, because he or she could be taking in extra air due to the cleft.
It’s important to have your baby weighed (naked) every week for the first month to ensure they’re growing. Keeping a log of your baby’s feedings is also helpful to track how much they’re eating.
If your baby’s healthcare provider has questions or concerns, he or she can call the Children’s Colorado cleft nurse at 720-777-5364.
The downloadable PDFs provide information on how to care for your child after surgery.
Supporting your baby’s feeding after cleft lip and/or cleft palate surgery
After cleft lip surgery
Within a few days after surgery, most babies can eat the way they were fed before the surgery. To lower the chance of injury to the lip, sometimes babies will feed from a special TenderCare™ Feeder or from a syringe with Brecht® tubing for the first few days after surgery.
After cleft palate surgery
Within a few days after surgery, most babies will go back to drinking the same amount of liquid as before the cleft palate surgery. Most surgeons will put the baby on a liquified diet (food put in a blender) after surgery and restrict use of a bottle to allow the surgical site to heal properly. The surgeon may suggest feeding from a special TenderCare™ Feeder, a syringe with Brecht® tubing, an open cup or a special sippy cup while your baby heals. The cleft nurse can offer guidance about specific cups to use after the cleft palate surgery.
Unilateral cleft lip: a split or opening (cleft) in one side of the lip; can partially slit like this example or completely open
Unilateral cleft lip: a split or opening (cleft) in one side of the lip; can completely open like this example or partially slit
Bilateral cleft:a cleft (split or opening) that occurs on both sides of the philtrum; can be completely open or partially slit
Bilateral cleft: a cleft (split or opening) that occurs on both sides of the philtrum; can be open on both sides like this example
Palate: roof of the mouth (made up of a hard section and a soft tissue section)
Submucous cleft: a cleft (split or opening) affecting the muscles that attach in the middle of the soft palate, but the visible skin is still intact
Cleft of the soft palate: a split or opening on the roof of the mouth affecting only the soft tissue section
Cleft of the hard and soft palate: a split or opening on the roof of the mouth affecting both the hard and soft tissue sections
Unilateral cleft: a split or opening (cleft) in one side of the lip or palate; can be completely open or partially slit
Bilateral cleft: a cleft (split or opening) that occurs on both sides of the philtrum
Auditory brain response (ABR): a type of hearing test often performed after an infant fails the initial newborn hearing exam or when unable to complete a successful hearing test; it is sometimes done under anesthesia
Alar cartilage: cartilage that forms the outer side of each nostril
Alveolus: the upper gum line; the part of the bony upper jaw that contains teeth
Articulation: the formation of speech sounds
Audiologic evaluation: a hearing test
Bilateral cleft: a cleft (split or opening) that occurs on both sides of the philtrum
Bone morphogenic protein (BMP): a growth hormone that stimulates bone growth; it is used to fill in the gap in the gum line where the gum (alveolus) is clefted at the time of the bone graft surgery
Cleft: a split or opening
Columella: tissue at the base of the nose that separates the nostrils
Congenital: existing at the time of birth
Cross bite: when the upper teeth sit behind the lower teeth, instead of in front of them
Deciduous teeth (baby teeth): a child’s first set of teeth; these teeth fall out as a part of normal development
Denasality: vocal quality that lacks a normal nasal sound (sounds like a stuffy nose); also known as hypo-nasality
Dental arch: the horseshoe shape of the upper gum
Effusion: collection of fluid in the middle ear space; common among children with cleft palate and can negatively affect hearing
Eustachian tube: the tube that connects the middle ear to the back of the throat
Fistula: an abnormal opening that can occur after surgical repair of the palate
Genetics: the science of genes and heredity
Hyper-nasality: greater than normal nasal quality during speech
Hypo-nasality: vocal quality that lacks normal nasal quality during speech (stuffy nose), (also known as denasality)
Malocclusion: incorrect positioning of upper teeth in relation to lower teeth
Mandible: the lower jaw, including the chin
Maxilla: the bony upper jaw, including the area above the upper lip and under the nose
Microform cleft: a very slight cleft (split or opening) in the lip or muscle of the lip
Mixed dentition: period of time when children have both baby teeth and permanent teeth
Nasal ala: wings or sides of the nostrils
Nasal emission: amount of air that flows through the nose during speech
Nasal regurgitation: food or liquids leaking out through the nose
Nasal septum: internal structure that divides the nasal cavity
Nasal endoscopy: a procedure in which a small camera is inserted through the nose to look at palate and throat movement during speech
Nostril retainer: plastic device used after surgical repair of the lip and nose to help hold the shape of the nostrils as the tissue heals or to help keep the nostrils open
Obturator: retainer-like device placed in the roof of the mouth to cover the cleft (split or opening); helps with feeding and speech development
Occlusion: relationship between the upper and lower teeth when they are in contact
Otitis media: ear infection
Palate: roof of the mouth (made up of a hard section and a soft tissue section)
Pharyngeal: relating to the pharynx or back of the throat
Philtrum: middle of the upper lip
Premaxilla: front central section of the upper gum usually containing the four upper front teeth
Prolabium: front portion of the upper lip
Resonance: quality of voice sound
Submucous cleft: a cleft (split or opening) affecting the muscles that attach in the middle of the soft palate, but the visible skin is still intact
Unilateral cleft: a split or opening (cleft) in one side of the lip or palate; can be completely open or partially slit
Uvula: small cone-shaped tissue that hangs down from the soft palate in the back of the mouth; looks like a little punching bag
Velopharyngeal closure: closure of the back end of the roof of the mouth (soft palate) and the back wall of the throat (pharynx)
Velopharyngeal insufficiency (VPI): occurs during speech without a good seal between the nose and the mouth; resulting in hypernasal speech as air escapes from the back of the throat
Vermillion: the vertical groove in the center portion of the upper lip
Vermillion border: where the red portion of the lip meets the lighter skin portion of the lip
Patient ratings and reviews are not available
Children's Hospital Colorado partners with NRC Health to gather star ratings and reviews from patients, residents and family survey data.
This provider either practices in a department or specialty that we currently do not survey, or does not have at least 10 ratings in the last 12 months. Learn more about patient ratings and reviews.
Provider affiliation
Children's Hospital Colorado providers
Children’s Hospital Colorado providers are faculty members of the University of Colorado School of Medicine. Our specialists are nationally ranked and globally recognized for delivering the best possible care in pediatrics.
Community providers
Some healthcare professionals listed on our website have medical privileges to practice at Children’s Hospital Colorado, but they are community providers. They schedule and bill separately for their services, and are not employees of the Hospital.