A cleft lip and a cleft palate are related congenital conditions in which the tissue from either side of the face in a developing fetus fails to knit together. The cleft affects 1 in 1,000 babies every year, making it the fourth most common birth defect in the United States. Because the lip and palate develop separately, it’s possible to have either defect alone or in combination, with the most common occurrence being both a cleft lip and palate.
At PNW Surgery in Portland, Oregon, Dr. Leo Urbinelli is a fellowship-trained leader in craniofacial surgery, and he puts his many years of specialized surgical experience to work repairing cleft lips and palates, as well as other craniofacial disorders.
Surgery is the best option for treating a child with such severe facial deformities. As such, our team wants parents to understand not only about the condition itself, but also how they can best support their child during the recovery process.
Cleft lips and palates occur at specific times during pregnancy. The lip develops between weeks 4-7. Tissues from each side of the head grow toward the center of the face, where they join to make the facial features. If tissue destined for the lip doesn’t join completely before birth, it results in an opening in the upper lip — from a small slit to a gap that extends up into the nose.
The palate (roof of the mouth) forms between weeks 6-9. A cleft palate occurs when the tissues from each side of the head don’t join completely on top. The baby might only have a partial opening, or the palate can be split both in the front and back.
Dr. Urbinelli treats cleft lips and palates with surgical techniques that reshape and rebuild the separated tissues. A cleft lip needs one or two surgeries, depending on the width and depth of the cleft. He generally performs the first surgery at about 3 months old, and the second, if needed, at 6 months old. Cleft lip repair always precedes cleft palate repair.
Cleft palate repair involves creating a working palate to allow for proper chewing and speech. At the same time, it helps reduce the chance of fluid developing in the middle ears. Children with cleft palates often need special tubes in their eardrums to aid fluid drainage, and these are often placed at the time of palate repair, which occurs at 12 months, before your child learns to talk.
No parent wants to see their child struggle with the pain and limitations of surgery, especially if the child is still an infant. But if your child has necessary procedures like cleft lip and palate repair, there are things you can do to make their recovery as quick and comfortable as possible.
It’s important to make sure your child drinks enough liquids to stay hydrated, which helps with recovery. You can gauge if your child is getting enough fluids if they have the same number of wet diapers as before the surgery. If they don’t have a wet diaper at least every eight hours, they need to drink more. For eating:
After about three weeks, the area should have healed enough that you don’t need to be as careful.
Arm splints keep your child’s arms from bending at the elbows, which prevents them from sticking their fingers or other objects in their mouths and damaging the stitches or reopening the wound. They usually need to wear them constantly for about three weeks.
Pain is normal after surgery, and Dr. Urbinelli either prescribes a pain reliever or recommends an over-the-counter variety to keep your child comfortable. He also prescribes an antibiotic to prevent infection. It’s important your child takes the medication exactly as directed, including taking the antibiotic until it’s gone.
Have questions about cleft lip and palate repair? Need more information on how to help your child post-surgery? Schedule your consultation with Dr. Urbinelli by giving PNW Plastic Surgery a call at 818-740-6142, or booking online today.