A cleft is a gap in either the upper lip, the roof of the mouth (palate) or sometimes both. It occurs when the separate areas of a babies face do not join properly in the womb. This can leave a gap below one or both nostrils or in the roof of the mouth. Surgery for cleft lip and palate can make a big difference to the development and growth of a child and is therefore often carried out in children between 3 to 12 months old. 

What does the operation involve?

A child with a cleft lip will usually undergo surgery to close the gap before they are three months old. Both lip and palate repair surgeries are carried out under general anaesthetic. A cleft lip operation usually lasts 1 to 2 hours during which the lip and underlying muscles are repaired and the nose is reshaped. Once completed the incision is closed up with stitches in the lip to create minimum scarring.

A cleft palate operation is usually undertaken before the child is 1 year old and lasts approximately 1.5 hours. During the operation the muscles and the lining of the palate are rearranged to close the separation.

What to expect post surgery?

> Your child will need to stay in hospital for 1 to 2 days after the operation.
> Mr Richard will see your child about 10 days after the operation.
> Your child’s hearing will be regularly assessed after surgery.
> Lip and cleft palate surgery will greatly reduce speech problems occurring. However, many children who undergo these repair operations will still require some speech therapy as they develop. A speech therapist will assess your child following surgery and again once they are 3 years old. They may require help with pronunciation and need speech and language therapy up until the age of 10 or more.
> In some cases, your child will require additional surgery later on in their development to improve appearance and function of the mouth. For example, if there is a gap in your child’s gum they will usually require a bone graft around 8 to 9 years old to help their permanent teeth to anchor properly.
> If the cleft involves the gum area, it is common for teeth to grow out of position. The health of your child’s teeth will be monitored and orthodontic treatment may be needed when their second teeth begin to grow.

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