• Cleft Lip and Cleft Palate Repair


    Cleft lip and cleft palate repair are surgeries of the lip and the roof of the mouth. These repairs are two separate surgeries that are sometimes done together.
    Surgery is usually done at a young age. Cleft lip repairs occurs most often at age 3-6 months. Cleft palate repairs occurs most often at age 9-18 months.
    Infant With Cleft Lip
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    These surgeries are done to repair birth defects called cleft lip and cleft palate. A cleft lip is an open gap in the upper lip. A cleft palate is an open gap in the roof of the mouth. If left untreated, the child can have many complications, such as:
    • Ear infections—fluid is not able to drain properly from the ear
    • Hearing impairment
    • Speech problems
    • Dental problems such as missing or malformed teeth
    • Feeding difficulties—A baby with a cleft lip may have a hard time sucking. A cleft palate can cause milk or formula to enter the nasal cavity.
    The goals of cleft lip repair are to:
    • Close the separation in the lip.
    • Create a curve in the middle part of the upper lip.
    • Create the right amount of distance between the upper lip and the nose.
    • Allow the lips to close with a tight seal.
    The goal of cleft palate repair is to have the palate area function normally. This includes proper development of the teeth and jaw, as well as speech.

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your child's doctor will review potential problems, like:
    • Bleeding
    • Infection
    • Scars not healing correctly
    • Reaction to the anesthesia
    • Damage to nerves, blood vessels, muscles, or lungs
    Additional birth defects may put your child at a higher risk for complications.
    Be sure to discuss these risks with the doctor before the surgeries.

    What to Expect

    Prior to Procedures

    Your child will need to have an empty stomach before surgery. Make sure you get specific instructions about when to stop feeding your child.
    In the time leading up to the surgeries, the doctor may have your child wear a device called an obturator. The device fits inside the mouth. It may help your child during feedings and help to keep the arch in the lip.
    Your child will be treated by a team of specialists. The doctors will:
    • Order tests such as blood tests, urine tests, and x-rays
    • Ask about your child’s medical history and do a physical exam
    • Give you a chance to ask questions about the surgeries and recovery process


    General anesthesia will be used. It will block any pain and keep your child asleep through the surgeries. It is given by IV.

    Description of the Procedures

    Cleft Lip Repair
    To repair a cleft lip, an incision will be made on either side of the cleft. The incision will be from the lip to the nostril. Sutures will be used to close the two parts of the lip. If your child has two openings on either side of the lip, an additional surgery will be needed in about a month. Bandages will be placed over the incision area.
    Cleft Palate Repair
    During cleft palate repair, incisions will be made on the two sides of the cleft. A special flap technique will be used to move the hard palate in the front of the mouth and the soft palate in the back of the mouth. The muscle fibers in the palate will also be moved. Removable or absorbable stitches will be used to close the area.

    Immediately After Procedures

    Your child will be brought into the recovery room. The hospital staff will monitor your child’s vital signs. In some cases, oxygen may be given through the nose.

    How Long Will It Take?

    • Cleft lip repair—about 2 hours
    • Cleft palate repair—2-4 hours

    How Much Will It Hurt?

    Anesthesia prevents pain during surgery. Your child will be given medication to relieve pain or soreness during recovery.

    Average Hospital Stay

    The surgeries are usually done in a hospital. For a cleft lip repair, your child may have to stay overnight. A longer stay may be required if an additional cleft repair is planned. If your child is having cleft palate repair, the hospital stay is usually 2-3 days.

    Post-procedure Care

    At the Hospital
    The hospital staff will:
    • Give your child nutrition and fluids through an IV, then later by mouth.
    • Give your child pain medication.
    • Use elbow splints to keep your child’s hands away from the incisions.
    Preventing Infection
    During your child's stay, the hospital staff will also take steps to reduce the chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your child's incisions covered
    There are also steps you can take to reduce your child's chance of infection such as:
    • Washing both you and your child's hands often, and reminding visitors and healthcare providers to do the same
    • Reminding your child's healthcare providers to wear gloves or masks
    • Not allowing others to touch your child's incision
    At Home
    To help ensure a smooth recovery for your child at home:
    • At first, your baby will be given fluids using a special bottle with a rubber-tip syringe or a spoutless cup. You will then be instructed to resume your baby’s normal breastmilk or formula feedings. If your child had cleft lip repair and is old enough, you will be able to feed them a soft diet using a spoon. If your child had cleft palate repair, start with a liquid diet, because food and utensils could interfere with the healing process.
    • If your school-age child had surgery, they may struggle with teasing from their classmates. Encourage your child to talk to you. Be there to listen to their concerns. Your child may also benefit from working with a therapist. This can help them cope with their condition and surgeries.
    • Apply sunscreen to your child’s face, especially on the healed incision area.
    After the surgeries, you will see scars at the upper lip and nose. These scars will fade with time. After the repairs are done, your child will be able to develop and function normally. In some cases, your child may need more surgeries to improve appearance. Surgeries may also be needed to improve breathing problems, jaw alignment, or speech development.

    Call Your Child’s Doctor

    It is important to monitor your child's recovery. Alert your child's doctor to any problems. If any of the following occur, call your child's doctor:
    • Bleeding
    • Signs of infection, including fever and chills
    • Irritability
    • Refusal to drink
    • Redness, swelling, increasing pain, or bleeding or discharge from the incision site
    • Cough or shortness of breath
    • Nausea or vomiting
    • New or unexpected symptoms
    Call for emergency medical services or go to the emergency room right away for:
    • Signs of dehydration —little or no urination, sunken soft spot on head in babies, no tears when crying, dry and cracked lips
    • Fast breathing or trouble breathing
    • Blue or gray skin color
    • Not waking up or not interacting
    If you think your child has an emergency, call for emergency medical services right away.


    Centers for Disease Control and Prevention https://www.cdc.gov

    National Institute of Dental and Craniofacial Research https://www.nidcr.nih.gov


    Birth Defect Research for Children http://birthdefects.org

    Health Canada https://www.canada.ca


    Cleft lip and cleft palate surgery. American Society of Plastic Surgeons website. Available at: https://www.plasticsurgery.org/reconstructive-procedures/cleft-lip-and-palate-repair. Accessed September 5, 2017.

    Cleft lip and palate. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/en/parents/cleft-lip-palate.html. Updated October 2014. Accessed September 5, 2017.

    Rosen H, Barrios LM, Reinisch JF, Macgill K, Meara JG. Outpatient cleft lip repair. Plast Reconstr Surg. 2003;112(2):381-387.

    What to expect: cleft lip surgery. University of Missouri Children’s Hospital, Pediatric Plastic Surgery website. Available at: https://www.muhealth.org/conditions-treatments/pediatrics/pediatric-plastic-surgery/cleft-lip-and-palate. Accessed September 5, 2017.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.