A cleft palate (PAL-it) is when a baby is born with an opening
(a cleft) in the roof of the mouth. This leaves a hole between the nose and the mouth.
The opening can:
just be in the back of the palate (the soft palate) or
extend into the front of the palate behind the gums (the hard palate)
Sometimes the opening in the palate can connect with an opening in the gums and
the lip (cleft
lip and palate). These orofacial clefts are some of the most common birth defects.
Most kids can have surgery to repair them early in life.
During the first 6
to 10 weeks of pregnancy, the bones and skin of a baby's upper jaw, nose, and
mouth normally come together (fuse) to form the roof of the mouth and the upper lip.
A cleft palate happens when parts of the roof of the mouth do not fuse together completely.
Doctors don't always know why a baby develops a cleft, though some clefts may be
related to genetic (inherited) factors. Also, some environmental factors can increase
the risk of a birth defect, such as:
taking certain medicines (such as some anti-seizure medicines) during pregnancy
have an oral exam soon after they're born. Doctors usually find a cleft palate when
they examine the inside of a baby's mouth during this exam.
How Is a Cleft Palate Treated?
A cleft palate usually is repaired with surgery called palatoplasty
(PAL-eh-tuh-plass-tee) when the baby is 10–12 months old. The goals of palatoplasty
Close the opening between the nose and mouth.
Help create a palate that works well for speech.
Prevent food and liquid from leaking out of the nose.
In this surgery, a plastic surgeon will:
Close the cleft in layers.
Rearrange and repair the muscles of the soft palate so they work better during
Make two incisions (cuts) on each side of the palate behind the gums to ease tension
on the palate repair.
This surgery requires general
anesthesia and takes about 2–3 hours. Most babies can go home after 1 or
2 days in the hospital. The stitches will dissolve on their own.
Your child will need a liquid diet for a week or two, then will eat soft foods
for several more weeks before going back to a regular diet. You may be asked to keep
your baby in special sleeves ("no-nos") that prevent the elbows from bending. This
is so your baby can't put any fingers or hard objects into the mouth, which could
make the cleft palate repair come open.
When Should I Call the Doctor?
Cleft palate surgery has greatly improved in recent years. Most kids who undergo
it have very good results. There are risks with any surgery, though, so call the doctor
if your child:
has a fever above 101.4°F (38.5°C)
has lasting pain or discomfort
has heavy bleeding from the mouth or nose
won't drink fluids
isn't making wet diapers
What Else Should I Know?
A child with a cleft palate can sometimes have other health problems, such as:
frequent ear infections
It's important to work with a care team experienced in treating children with cleft
lip and palate. Besides the pediatrician, a child's treatment team will include:
ear, nose, and throat (ENT) physician (otolaryngologist)
You might also work with:
an oral surgeon
a social worker
a psychologist or therapist
a team coordinator
Some kids with cleft palate may need other surgeries as they get older. These might
Speech surgery: Children can develop speech problems even after
the palate has been repaired. At your regular appointments with the cleft team, the
pathologist will carefully listen to your child's speech to help the surgeon decide
if another surgery is needed to improve speech.
Orthognathic (or-thig-NATH-ik) surgery: Some
children with cleft palate need this surgery to realign the jaws and teeth when they're
older. It's done when the child is finished growing.
Most kids with cleft palate are treated successfully with no lasting problems.
A team experienced in treating children with cleft lip and palate can create a treatment
plan tailored to your child's needs.
The psychologists and social workers on the treatment team are there for you and
your child. So turn to them to help guide you through any hard times. You also can
find more information and support online: