The sections below show the care pathways for children born with the following conditions:
- cleft lip and / or alveolus
- cleft palate only
- unilateral cleft lip and palate (UCLP)
- bilateral cleft lip and palate (BCLP)
- submucous cleft palate (SMCP)
Please note that all children with a cleft are individually assessed and your child’s care plan may deviate from these pathways.
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Cleft lip and / or alveolus
Download our record book to help you keep track of your child’s appointments and progress over time.
Antenatal diagnosis
You will be contacted by a cleft nurse specialist within 24 hours of your referral being received. A virtual or home visit will be offered.
Birth
A cleft nurse specialist will arrange to see you and your baby within 24 working hours of referral. A cleft nurse specialist will also visit you at home within one week of discharge. You will be offered an appointment with a consultant plastic surgeon at the clinic within four to six weeks.
3 to 4 months
Your baby will have surgery to repair their cleft lip. The surgery will be reviewed by a cleft nurse specialist in the clinic approximately six weeks after surgery.
Download our leaflet on cleft lip repair.
6 to 9 months
Your child will attend a specialist clinic (Early Intervention Clinic) where they will be seen by a:
- specialist nurse
- paediatric dentist
2½ to 3½ years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic.
5 to 6 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
7 years
If alveolus is involved, your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Your child will be referred to the Alveolar Bone Graft (ABG) Clinic if appropriate.
8 to 11 years (if required)
If alveolus is involved, your child may require alveolar bone grafting surgery. This will be discussed at the Alveolar Bone Graft Clinic.
Download our leaflet on alveolar bone grafting.
Your child may also require orthodontic treatment, which is usually provided in the local hospital orthodontic unit.
10 to 11 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
15 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Nasal correction will be carried out if required. Your child will be discharged if no further work is necessary.
Download our leaflet for people who are leaving the care of the Cleft Team.
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Cleft palate only
Download our record book to help you keep track of your child’s appointments and progress over time.
Birth
A cleft nurse specialist will arrange to see you and your baby within 24 working hours of referral. A cleft nurse specialist will also visit you at home within one week of discharge. You will be offered an appointment with a consultant plastic surgeon at the clinic within four to six weeks.
6 to 12 months
Your child will attend a specialist clinic (Early Intervention Clinic) where they may be seen by a:
- specialist nurse
- speech and language therapist
- paediatric dentist
6 to 12 months
Your child will have their palate repaired. The palate repair will be reviewed between four and six weeks after surgery.
Download our leaflet on cleft palate repair.
12 months
You will be invited to attend a parent webinar by the speech and language therapist. This aims to help you develop your child’s speech, language and communication skills.
2½ to 3½ years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic by a:
- consultant cleft surgeon
- speech and language therapist
- dentist
- audiologist
5 to 6 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
10 to 11 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
15 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Your child will be discharged if there are no issues.
Download our leaflet for people who are leaving the care of the Cleft Team.
Download our leaflet for people leaving speech and language therapy.
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Unilateral cleft lip and palate (UCLP)
Download our record book to help you keep track of your child’s appointments and progress over time.
Antenatal diagnosis
You will be contacted by a cleft nurse specialist within 24 hours of your referral being received. A virtual or home visit will be offered.
Birth
A cleft nurse specialist will arrange to see you and your baby within 24 working hours of referral. A cleft nurse specialist will also visit you at home within one week of discharge. You will be offered an appointment with a consultant plastic surgeon at the clinic within four to six weeks.
4 to 6 months
Your baby will have surgery to repair their cleft lip. The surgery will be reviewed by a cleft nurse specialist in the clinic approximately six weeks after surgery.
Download our leaflet on cleft lip repair.
6 to 9 months
Your child will attend a specialist clinic (Early Intervention Clinic) where they may be seen by a:
- specialist nurse
- speech and language therapist
- paediatric dentist
12 months
Your child will have their palate repaired. The palate repair will be reviewed between four and six weeks after surgery.
Download our leaflet on cleft palate repair.
You will also be invited to attend a parent webinar by the speech and language therapist. This aims to help you develop your child’s speech, language and communication skills.
18 months
Your child will be invited for assessment by a speech and language therapist.
2½ to 3½ years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic by a:
- consultant cleft surgeon
- speech and language therapist
- dentist
- audiologist
5 to 6 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken. Your child will be assessed by the same specialists as above, plus a psychologist.
7 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic.
8 to 11 years
Your child will have alveolar bone graft surgery. Download our leaflet on alveolar bone grafting.
Your child may also require orthodontic treatment, which is usually provided in the local hospital orthodontic unit.
10 to 11 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
15 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Nasal correction will be carried out if required.
18 years
Orthognathic (jaw) surgery will be considered at this stage if required.
20 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Your child will be discharged if there are no issues.
Download our leaflet for people who are leaving the care of the Cleft Team.
Download our leaflet for people leaving speech and language therapy.
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Bilateral cleft lip and palate (BCLP)
Download our record book to help you keep track of your child’s appointments and progress over time.
Antenatal diagnosis
You will be contacted by a cleft nurse specialist within 24 hours of your referral being received. A virtual or home visit will be offered.
Birth
A cleft nurse specialist will arrange to see you and your baby within 24 working hours of referral. A cleft nurse specialist will also visit you at home within one week of discharge. You will be offered an appointment with a consultant plastic surgeon at the clinic within four to six weeks.
2 to 3 months
Your baby will have bilateral lip adhesion. Download our leaflet on cleft lip adhesion.
4 to 6 months
Your baby will have their definitive cleft lip and hard palate repair. The surgery will be reviewed by a cleft nurse specialist in the clinic approximately six weeks after surgery.
Download our leaflet on cleft lip repair.
6 to 9 months
Your child will attend a specialist clinic (Early Intervention Clinic) where they may be seen by a:
- specialist nurse
- speech and language therapist
- paediatric dentist
12 months
Your child will have their palate repaired. The palate repair will be reviewed between four and six weeks after surgery.
Download our leaflet on cleft palate repair.
You will also be invited to attend a parent webinar by the speech and language therapist. This aims to help you develop your child’s speech, language and communication skills.
18 months
Your child will be invited for assessment by a speech and language therapist.
2½ to 3½ years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic by a:
- consultant cleft surgeon
- speech and language therapist
- dentist
- audiologist
5 to 6 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken. Your child will be assessed by the same specialists as above, plus a psychologist.
7 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic.
8 to 11 years
Your child will have alveolar bone graft surgery. Download our leaflet on alveolar bone grafting.
Your child may also require orthodontic treatment, which is usually provided in the local hospital orthodontic unit.
10 to 11 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
15 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Nasal correction will be carried out if required.
18 years
Orthognathic (jaw) surgery will be considered at this stage if required.
20 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Your child will be discharged if there are no issues.
Download our leaflet for people who are leaving the care of the Cleft Team.
Download our leaflet for people leaving speech and language therapy.
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Submucous cleft palate (SMCP)
Download our record book to help you keep track of your child’s appointments and progress over time.
Download our leaflet on submucous cleft palate.
Referred to cleft service
Your child will be seen at a specialist clinic (the Joint Cleft Palate Clinic) within six months of referral by a:
- consultant plastic surgeon
- speech and language therapist
Submucous cleft confirmed
If an asymptomatic submucous cleft is confirmed (no symptoms), your child will be discharged (you can self-refer again at any time). This is sometimes referred to as a bifid uvula.
If a symptomatic submucous cleft is confirmed (symptoms present), further assessment will be required or your child will be added to a waiting list for cleft repair. We aim to carry out cleft repair within six months of diagnosis.
2½ to 3½ years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic (if your child’s cleft was repaired by the age of four).
5 to 6 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken (if your child’s cleft was repaired by the age of six).
10 to 11 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Audit records will be taken.
15 years
Your child’s progress will be reviewed at the Joint Cleft Palate Clinic. Your child will be discharged if there are no issues.
Download our leaflet for people who are leaving the care of the Cleft Team.
Download our leaflet for people leaving speech and language therapy.