Cleft lip and/or palate malformation is caused by a failure of the normal oro-facial development between 6 and 12 weeks of intrauterine life. The incidence is 1:1000 Caucasian births and higher in Asian populations. It is more common in males and can be associated with other abnormal structures.
All infants born with a cleft lip and/or palate should be assessed immediately after birth by the paediatric team. This assessment determines if there are any airway concerns, and if so, what is the appropriate form of monitoring, where the baby should be monitored and if there are any other associated anomalies. At this review a feeding plan also needs to be formulated with parents. In mild cases, baby needs admission to NICU for 3 – 4 days for establishment of feeds, parent education and resolution of breathing difficulties.
During admission, the child is also assessed by the plastic surgical team to discuss the timing of definitive surgery for the lip and palate. Repair of the lip occurs at approximately 3 - 6 months and repair of the palate at 6 - 9 months.