You want the best for your baby, and so do we. If a routine ultrasound shows that your baby will be born with a cleft lip, we are here to help you prepare. We want you to be able to focus on welcoming your baby.

You won’t know until birth if your baby will also have a cleft palate. Cleft lip and cleft palate are common conditions and can be repaired. Our expert team will guide you through what may be years of treatment for your child.

On this page, you’ll find what to expect when you have a child with a cleft lip or a cleft palate.

Preparing for your child’s birth

After your child’s cleft lip is seen on ultrasound, your prenatal care provider will likely refer you to a specialist to help you plan for your baby’s treatment.

At OHSU Doernbecher Children’s Hospital, you will first meet with our nurse practitioners. They will:

• Conduct a full health exam.
• Provide resources to help you care for your newborn.
• Explain the treatment options, which may include surgery.
• Answer any questions you have.
• Connect you with a care coordinator who will offer ongoing support.

Some infants with cleft lip or cleft palate are not able to breastfeed. We may give you custom bottles to help you feed your baby without the need for sucking.

First appointment

For a cleft lip, you will meet your child’s reconstructive surgeon and other care team members within weeks of birth. For a cleft palate, you will meet them within one week. Your care team will include a nurse practitioner, a social worker, and speech and hearing specialists as needed. Your care coordinator will also attend and be your primary contact with us.

At this appointment, we may discuss whether your child would benefit from a presurgical treatment called nasoalveolar molding. This approach uses a device similar to a dental retainer to make the cleft smaller before surgery. The treatment requires weekly visits for adjustments.

First surgery

Surgery for a cleft lip usually takes place when your baby is three to five months old. The surgery takes about three hours. In most cases, your child can go home the same day.

The first surgery for a cleft palate usually takes place at around 12 months old. If testing shows your child may have hearing issues, the surgeon may also place tiny tubes in the eardrum. These tubes create an opening to prevent fluid buildup.

After one year

Our team will work with you to establish a dental plan for your child, starting at age one. We offer dental and orthodontic work at the OHSU School of Dentistry, or you can choose dentists or orthodontists in your community. Our team will help you find providers close to home and work with them on a treatment plan.

Ages 2 to 5

If your child has a cleft lip without a cleft palate, you can expect follow-up visits once a year. If your child has speech or hearing problems, you can also expect visits with a speech pathologist or other specialists. Children with cleft palates can expect follow-up visits every six months to prepare for additional surgeries or treatments.

Ages 5 to 15

You and your child will have access to our craniofacial specialists and OHSU resources during this time. We will tailor ongoing treatment to your child’s specific needs. Our goal is to provide the best possible care as your child grows.

• A child with a cleft palate may need additional surgery for palate, gum or jaw repair.
• A child with a cleft lip may need additional surgery to improve the function or appearance of their nose or lip.
• We may recommend surgery to attach bone to the gum line when your child is 8 to 10 years old. This is called an alveolar bone graft.
• Your child is likely to need braces or other orthodontics in the early teen years.