First 2 Weeks

• After the Cleft Lip Palate Clinic receives confirmation of your baby’s birth, we will phone you to set up initial consult appointments with speech-language pathologist and plastic surgeon.
• Your first visit will be approximately 1 ½ hours long. During this appointment information about the clinic will be given and both feeding and swallowing issues, and surgical options will be discussed.
• Nasolaveolar molding appliance (NAM): If the plastic surgeon recommends this appliance, you will be phoned about an appointment to take the impression for the NAM. After that, the orthodontist will set up a treatment program with you.

Up to 6 Months

• NAM: (for babies with cleft lip with gum involvement) weekly or biweekly visits with the orthodontist to adjust the NAM. The orthodontist will recommend when your baby is ready for the cleft lip repair.
• Auditory Brainstem Response Test (ABR) (for all babies with a cleft palate):  A hearing test that measures response to sounds, which requires the baby to be sleeping. The ABR test is completed when your child is about 3 months old.
• Cleft lip repair: The plastic surgeon will recommend when the lip will be repaired after the initial consult appointment. The plastic surgeon’s office will contact you with a tentative date for surgery.
• Genetics: Referrals are made for some newborns with a cleft palate. Their office will contact you about an appointment.
• Respirology: A referral will be sent if any providers on the cleft team feel the need for your child to see this service.
• Speech pathology: Follow up for feeding and swallowing if necessary. 

9 to 18 Months

• Cleft palate repair: The plastic surgeon will recommend when the palate will be repaired after the initial consult appointment, or the plastic surgeon will ask the clinic to bring your child back for an appointment before surgery. The plastic surgeon’s office will contact you with a tentative date for surgery.
• Speech, ENT, and audiology: Before cleft palate repair appointments with each of these providers at approximately 9 months of age.
• ENT: If ear tubes are needed, they are inserted at the same time the cleft palate is repaired.
• Speech: After surgery appointment at 18 months

3 to 5 Years

• Speech, ENT (and audiology if needed):  Your child will come into the clinic for these routine appointments every year until 5 years old. *Note this applies to only to children who have a cleft palate. 
• Speech, ENT (audiology if needed), plastics, pediatrician, and orthodontics:  At 3 years of age all cleft lip and/or palate children will come into the clinic for a full day assessment with these services.
• Note for the parents of children with a cleft lip only:  Your child’s next appointment will be at 12 years of age unless any of the services ask to see your child, or you call and request a follow up appointment. 

6 to 15 Years

Orthodontist:  if your child’s cleft involves his/her alveolar ridge, the orthodontist will need to see your child at 7 years of age, to make a consult to the Oral Maxillary Surgeon for an alveolar bone graft.

• Possible speech appointments
• Possible surgical revisions
• Possible oral implants (14 to 17 years of age)
• Possible genetics referral
• Possible follow ups as requested by parents.