Cleft Lip and Palate

Pre –operative care and surgery

A child who is born with a cleft lip and /or palate in the U.K. will usually have the cleft in the lip closed (operated on) at 3 months of age and the cleft in the palate closed at 6 -9 months of age. These children may also need other operations throughout childhood and into adulthood (see ‘Cleft treatment pathway’). It is not always necessary for a child with a very small cleft lip to have an operation – sometimes small lip closures are done only for cosmetic reasons. All of the parents we spoke to whose child had a cleft lip had agreed that their child should have their lip closed at approximately 3 months of age. Similarly, all parents whose child was born with a cleft palate had consented to have their child’s palate closed or were making preparations for future surgery. Prior to having a cleft lip and/or palate repair it is important that the child is free from coughs and colds, chicken pox and other viral infections as the surgical team will not operate if a child is unwell. This can delay the closure of a cleft lip and/or palate.
All families have the opportunity to discuss any surgery their child might undergo at a multi-disciplinary team (MDT) meeting and they can ask questions directly to the surgeon who will perform the lip and/or palate closure. A clinical nurse specialist (CNS) will also be contactable to answer any questions that families might have regarding surgery for cleft lip and/or palate. 
One of the issues is that any surgery on the face will alter the child’s appearance and so parents and other family members will need to adapt to the fact that their child will look different after the operation.
Knowing that their child would be anaesthetised and have an operation caused concern for parents. Many mothers and some fathers found it difficult to watch their child have a general anaesthetic before their operation. It was common for the child’s father to be there when the mask was placed on the baby’s face. Mothers’ were more likely to stay overnight in hospital – usually for one night only before the child is discharged and allowed to go home.
The surgery to close cleft lip and palate can take between 2 and 3 hours but this depends on the type of cleft (unilateral – one sided cleft – or bilateral – 2 sided cleft) and whether, for example, the nose is affected.
In rare cases a cleft palate can split again during the healing process after it has been closed for no apparent reason and the child will have to undergo surgery again.
Last reviewed June 2017.


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