Cleft Lip and Cleft Palate

With the right treatment, most children with cleft lip or cleft palate lead full, healthy lives. At Rush, you’ll find a caring, experienced team of experts who can guide your family through every stage of the care your child needs.

Remarkable Care for Kids

• Comprehensive, coordinated care: According to the American Cleft Palate – Craniofacial Association, kids with cleft lip or cleft palate do best when they receive care from a coordinated team of specialists.
  That’s exactly what happens at Rush. The cleft lip and cleft palate program at the Rush Craniofacial Center brings together craniofacial surgeons, orthodontists, speech-language pathologists, feeding specialists, pediatric ear, nose and throat specialists, audiologists, pediatric psychologists, genetic counselors and pediatric primary care providers.
• Team appointments focused on the whole child: The Rush Craniofacial Center offers team appointments where families can see multiple specialists at one time. This minimizes the number of appointments your child needs and ensures that their treatment plan is focused on all aspects of their well-being.
• Advanced fetal and neonatal care: If you’re expecting a baby with cleft lip or cleft palate, specialists in the Fetal and Neonatal Medicine Center at Rush can provide coordinated mother-baby-family care for your pregnancy and beyond. Right after birth, your baby can receive care in Rush’s level III neonatal intensive care unit — the highest possible designation for a NICU.

What are cleft lip and cleft palate?

Cleft lip happens when the left and right sides of a baby’s upper lip don’t fully come together before birth. Cleft palate happens when the left and right sides of a baby’s palate (the roof of the mouth) don’t fully come together before birth. 

About half of children with these conditions have both cleft lip and cleft palate. About 30 percent have only cleft palate, and about 20 percent have only cleft lip.

Cleft lip and cleft palate can lead to difficulties with speaking, hearing, eating, swallowing and breathing. It can also affect children’s appearance and self-esteem. But surgery and other therapies can effectively treat these problems.

Cleft lip and cleft palate causes

There are many possible causes of cleft lip and cleft palate. In most cases, the cause is unknown. But women might have a higher risk of having a child with these conditions in the following cases:

• They smoke during pregnancy
• They have diabetes
• They take certain antiseizure medicines, such as topiramate or valproic acid, during the first trimester of pregnancy
• They, or the other biological parent, has a family history of cleft lip or cleft palate

Diagnosis of cleft lip and cleft palate 

Doctors usually diagnose cleft lip and cleft palate before birth (during an ultrasound) or right after birth. In some cases, a cleft palate may not be diagnosed until a few days after birth or even until a child begins speaking.

Care for cleft lip and cleft palate at Rush

The Rush Craniofacial Center brings together a team of specialists who will work closely with you — and each other — to create a treatment plan for your child. That plan will include one or more of the following:

Fetal and neonatal care

• Prenatal counseling: If you’re preparing for the birth of a baby with cleft lip or cleft palate, maternal-fetal medicine specialists, neonatologists and the craniofacial team at Rush can help develop a plan even before your child is born.
• Top-notch neonatal care: Right after birth, your baby will receive care in Rush’s Renée Schine Crown Neonatal Intensive Care Unit (NICU), where you’ll find around-the-clock neonatologists and nurses with advanced training.
• Help with feeding: At Rush, you’ll have access to advanced practice nurses and speech-language pathologists who are specially trained to help children with clefts feed properly. You’ll also have access to lactation consultants, who can help with breastfeeding.

Surgery and presurgical molding

Surgery can repair cleft lip and cleft palate. It typically reduces or removes visible signs of the cleft. It can also help your child with speech, hearing, breathing or swallowing difficulties. The team at Rush offers a range of surgical and presurgical services:

• Naso-alveolar molding: Before surgery, many children with clefts benefit from molding procedures designed to begin the process of repairing the lip, nose or upper jaw bone. This type of procedure, known as naso-alveolar molding, is typically prescribed by your surgeon and performed by your orthodontist.
• Cleft lip repair surgery: Your child will undergo surgery to repair the cleft lip within the first few months of life.
• Cleft palate repair surgery: Surgeons usually perform surgery to repair a cleft palate when your child is between 9 and 18 months old, depending on the severity of the cleft.
• Additional surgeries, as needed: Some children need additional surgeries as they get older. The timing and number of procedures depends on several factors, and every child is different. Your child’s craniofacial surgeon at Rush will work with your family to determine what’s right for your child.

Nonsurgical care

• Orthodontic services: As your child grows, they may need braces or other orthodontic care for extra, missing, crowded or crooked teeth. At Rush, your child will have access to experienced orthodontists who specialize in caring for children with cleft lip and cleft palate.
• Care for airway, swallowing and feeding problems: Specially trained advanced practice nurses and speech-language pathologists will provide instruction and tips to help ensure that your baby is getting enough to eat. After surgery, your child can receive additional care for any breathing, swallowing or feeding problems from a dedicated pediatric ear, nose and throat specialist.
• Speech-language therapy: For help with speaking and language development, your child can see a speech-language pathologist who specializes in treating kids with cleft lip and cleft palate.
• Audiology services: Rush is one of only a handful of hospitals where the craniofacial team includes an audiologist. Audiologists specialize in treating hearing impairment, a common condition among children with cleft lip or cleft palate.
• Psychological counseling: Pediatric psychologists at Rush can help address any self-esteem, neurodevelopmental or emotional difficulties your child may be dealing with.
• Comprehensive care: Pediatricians at Rush University Children’s Hospital will work with you, your child and your child’s craniofacial care team to provide coordinated follow-up care for cleft lip and cleft palate.
• Genetic counseling: In most cases, doctors don’t know what has caused cleft lip or cleft palate. In some cases, genes may play a role. Genetic counselors at Rush can help your family measure the risk of cleft lip or cleft palate affecting children you may have in the future.