A cleft is usually treated with surgery. Other treatments, such as speech therapy and dental care, may also be needed.

Your child's care plan

Children with clefts will have a care plan tailored to meet their individual needs. A typical care plan timetable for cleft lip and palate is:

Why would someone get a labiaplasty?

There are medical reasons for labiaplasty. There are also physical, cosmetic and emotional reasons. Sometimes, labiaplasty is part of gender-affirming surgery.

Lip repair surgery

Lip repair surgery is usually done when your baby is around 3 months old.
Your baby will be given a general anaesthetic (where they’re unconscious) and the cleft lip will be repaired and closed with stitches.
The operation usually takes 1 to 2 hours.
Most babies are in hospital for 1 to 2 days. Arrangements may be made for you to stay with them during this time.
The stitches will be removed after a few days, or may dissolve on their own.
Your child will have a slight scar, but the surgeon will try to line up the scar with the natural lines of the lip, to make it less noticeable. It should fade and become less obvious over time.

Palate repair surgery

Palate repair surgery typically occurs between 6 to 12 months of age. The procedure involves closing the gap in the roof of the mouth, rearranging the muscles and lining, and sealing the wound with dissolvable stitches. The operation usually lasts around 2 hours and requires general anesthesia. Hospital stays typically range from 1 to 3 days, with arrangements often available for parents to stay with their child. The resulting scar from the surgery will be located inside the mouth.

Additional surgery

In some instances, additional surgery may be necessary at a later stage to address specific concerns, such as repairing a cleft in the gum with a bone graft, typically done between 8-12 years old. Further surgery may also be required to refine the appearance and function of the lips and palate, correct nasal shape, or improve the jaw’s appearance, particularly if the lower jaw is underdeveloped or set back.

What causes a labium to become oversized?

Feeding help and advice

Babies with a cleft palate often face challenges with breastfeeding due to the gap in the roof of their mouth. They may struggle to form a seal, leading to air intake and milk escaping through the nose. This can also hinder weight gain in the first few months. A specialist cleft nurse can provide guidance on positioning, alternative feeding methods, and weaning if necessary. If breastfeeding isn’t possible, expressing breast milk into a specialized bottle for babies with cleft palates may be recommended. In rare cases, tube feeding through the nose may be necessary until surgery can be performed.

Treating hearing problems

Children with a cleft palate are at a higher risk of developing glue ear, a condition where fluid accumulates in the ear, potentially impairing hearing. Regular hearing tests will be conducted to monitor for any issues. Fortunately, hearing problems may resolve after cleft palate repair, and if necessary, can be treated with the insertion of tiny plastic tubes, called grommets, into the eardrums to facilitate fluid drainage.

Dental care

Children with a cleft involving the gum area often experience dental issues, such as tilted or misplaced teeth, missing or extra teeth. A pediatric dentist will monitor their dental health and provide necessary treatment. Registering with a family dentist is also crucial. Orthodontic treatment, including braces or dental appliances, may be required to improve tooth alignment and appearance. This treatment typically begins after baby teeth have fallen out, but may be necessary before a bone graft to repair the gum cleft. Additionally, children with clefts are more prone to tooth decay, emphasizing the importance of good oral hygiene and regular dental visits.

Speech and language therapy

Repairing a cleft palate significantly reduces the likelihood of speech problems, but some children may still require speech therapy. A speech and language therapist will regularly assess your child’s speech as they grow, identifying any issues and recommending further evaluation or therapy to develop clear speech. Ongoing monitoring and support will be provided until your child reaches full growth. In some cases, additional corrective surgery may be necessary to address nasal-sounding speech caused by excessive airflow through the nose.

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