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So Your Child Can Find Their Smile

From the first moment you realize your life is going to change to the first time you hear that precious heartbeat, you imagine every inch of your new baby. We know a diagnosis of cleft lip or cleft palate can be surprising and overwhelming. While cleft lip and palate are some of the most common birth defects that affect a baby’s face, that doesn’t make the diagnosis any easier for parents to hear.

At AdventHealth for Children, our compassionate and experienced team of experts is here for you. While we have successfully cared for thousands of children with cleft lip-and palate-related conditions, we know each patient and family is unique. We’re here to answer your questions, discuss your childs treatment options and create a plan thats best for your baby.

With unmatched skills and expertise across Central Florida, our craniofacial team is backed by a network of over 250 pediatric specialists who work together and in partnership with your family to care for your child.

Our pediatric plastic surgeons are ready to help your child smile again. To get started, request an appointment and our Nurse Care Coordinator will contact you.

Dr. Raj Sawh-Martinez, Medical Director for Pediatric Plastic Surgery

Video Series: Cleft Palate and Cleft Lip

Dr. Raj Sawh-Martinez, Medical Director for Pediatric Plastic Surgery at AdventHealth for Children, discusses cleft lip and cleft palate conditions, how they differ from each other and the best treatment options to help babies thrive.

Understanding Cleft Lip

One of the most common craniofacial conditions, a cleft lip is the separation of the two sides of the upper lip area. It can occur when the tissue that makes up a baby’s lip does not completely join before birth, and as a result, there is as an opening or gap in the skin of the upper lip. Having your baby born with a cleft lip can be frightening to any parent. However, it is important to know that a cleft lip can be corrected. Surgery can help restore function and a more normal appearance, and most children go on to lead full, healthy lives after treatment.

Causes

The underlying cause of cleft lift is still widely unknown. It is important that you, as the parent, don’t feel like you are to blame for the anomaly. While it is suggested these conditions could be genetic, it is still very much a mystery. There is a greater chance of having a child with a cleft lip if a parent or sibling has one. Most children affected with cleft lips develop their facial difference without a known or direct link to exposures during or after pregnancy. A few exceptions that are associated with the development of cleft lip include:

  • Smoking while pregnant leads to a twofold increase in the risk of developing a cleft lip.
  • Taking Phenytoin (Dilantin) during pregnancy makes cleft lip 10 times more likely to occur.
  • Using alcohol, anti-seizure medicines or Vitamin A (retinoic acid) is linked with birth defects, including cleft lip.
Diagnosis

Diagnosis is often discovered at birth but can also sometimes be detected by prenatal ultrasound. If a cleft lip has been discovered via an ultrasound during pregnancy, we understand you will want answers as soon as possible. Our specialized team is ready to provide you guidance and can even connect with you and your family prior to your child's birth to create a plan of care once your baby arrives.

If a cleft lip is discovered after birth, expertly trained craniofacial plastic surgeons should conduct a thorough diagnosis through a multidisciplinary team evaluation. Once a diagnosis is presented, we can guide you through the treatment process and what the best care plan would be for your child.

Treatment

At AdventHealth for Children, cleft lip repair is typically performed between 3-6 months of age. It may require pre-surgical orthodontic treatments (nasoalveolar molding or Latham appliance) along with one or two surgeries depending on the extent of the malformation and patient-specific considerations. Also referred to as NAM, nasoalveolar molding is a nonsurgical way to reshape the gums, lip and nostrils with a plastic plate before surgery. A Latham appliance is a device that is utilized to help decrease the width of the cleft prior to surgery.

If two surgeries are determined to be necessary, the first surgery may be performed at 2-2.5 months of age followed by a definitive cleft lip repair around 5-6 months of age.

Our dedicated Cleft and Craniofacial Nurse Care Coordinator will guide you through each step of your child’s treatment, including surgery, so you always feel supported.


Questions to Your Answers About Cleft Lip

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Your Child's Cleft Lip and Palate Care Team

We believe in providing whole-person care to achieve the best outcomes. As a result, your child will be cared for by a multidisciplinary team of expert providers who have the highest level of certification and training in their respective fields. This team may include any of the following providers depending on your child's unique care needs.
  • Audiologists
  • Anesthesiologists
  • Complex Care Pediatricians
  • Dentists
  • Ear Nose and Throat (ENT) Physicians
  • Genetic Specialists
  • Nurse Care Coordinator
  • Oral Surgeons
  • Orthodontists
  • Plastic and Reconstructive Surgeons
  • Physician Assistants
  • Registered Dieticians
  • Speech, Language and Feeding Therapists
  • Social Workers

Understanding Cleft Palate

A cleft palate involves a separation or opening in the roof of a baby’s mouth that can occur early in a pregnancy. One of the most common birth defects, it happens when the baby’s developing facial tissues don’t fully join together. While a diagnosis of cleft palate can feel scary and overwhelming, it is a treatable condition. Surgery to repair the cleft can improve both function and appearance, allowing most children to lead normal lives.

Causes

A cleft palate is a facial and oral malformation that happens very early in pregnancy while your baby is still developing. Although the exact underlying causes are still widely unknown, approximately 20-50% of babies born with cleft palates may have a syndromic association. There are hundreds of named syndromes that may be associated with cleft palate.

Diagnosis

Most of the time, a cleft palate is diagnosed after a baby is born. However, there may be times that a cleft palate can be seen on a prenatal ultrasound while the mother is still pregnant. In these cases, you can prepare with the knowledge of future treatments for your baby once they are born and even meet with our Cleft and Craniofacial team for a consultation so that you can feel confident and ready when the time for cleft palate care arrives.

Treatment

Cleft palate repair is performed between 10 and 12 months of age and is a bit more complex than cleft lip repair. It may require multiple surgeries over the course of the child’s childhood, up to 18 years of age. This can include a bone graft on the upper gum line at around 8 years of age to support the growth of permanent teeth. Our care team will help guide your family throughout the process and help you navigate care and treatment.


Answers to Your Questions About Cleft Palate

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Sean Jackson

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Patient Testimonial

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​​​​​He smiles now and is happy with himself! I couldn’t have asked for a better cleft team!! My husband and I are so grateful for his knowledge and caring about Sean! – Mom

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Expert and Compassionate Care

Our team is here to help heal your child’s body, mind and spirit. We’ll work with specialists across medical fields to ensure your little one gets the care, attention and therapy they deserve to live well, be happy and thrive.

Why Choose Us

At AdventHealth for Children, our team of plastic and reconstructive surgeons care for your child’s and family’s body, mind and spirit with comprehensive, compassionate care.

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Experienced Care for Your Child

Get access to proven approaches for correcting cleft lip and cleft palate in your baby. Find a plastic surgeon near you and learn more about our surgical outcomes.