Skip to Main Content Skip to Site Map Skip to Accessibility Statement

Care pathways for cleft lip and / or palate

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.

You can also download a range of useful information leaflets produced by our cleft lip and palate team.


  • 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.

    You can also download the ‘Moving Up’ leaflet, which has information to help with the switch from primary to secondary school.

    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.

  • 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. A cleft nurse specialist will visit you at home within a week of your child being discharged. 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.

  • 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. A cleft nurse specialist will visit you at home within a week of your child being discharged. 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.

    You can also download the ‘Moving Up’ leaflet, which has information to help with the switch from primary to secondary school.

    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.

  • 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 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. A cleft nurse specialist will visit you at home within a week of your child being discharged. 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.

    You can also download the ‘Moving Up’ leaflet, which has information to help with the switch from primary to secondary school.

    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.

  • 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).

    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.