Comprehensive Care Timeline
Birth-2 weeks old
- Feeding evaluation with a pediatric nurse practitioner or speech-language pathologist
4-12 weeks old
- Clinic visit with cleft/craniofacial surgeon; consideration of cleft lip taping
- Orthodontic visit for pre-surgical molding device, if needed
Weekly Clinic Visits for 2-3 months
- Clinic visit to adjust Nasal Alveolar Molding (NAM)
- Clinic visit for feeding follow up and weight checks
The First Year
- Cleft lip closure 3-5 months
- Speech and behavioral audiogram at approximately 8 months of age
- Cleft palate closure 10-14 months, depending upon development and airway
- Ear tubes may be placed at during cleft lip or palate surgeries
- First panel appointment
2-5 years
- Clinic visits to cleft/craniofacial surgeon at least once a year
- Speech evaluation every 6 months until normal development is established
- Annual hearing tests, more often if ear tubes are placed
- First dental evaluation at 12-18 months
- Cleft/Craniofacial Team Panel visit
School age years
- Annual clinic visits to cleft/craniofacial surgeon
- Speech therapy, if needed
- Nasopharyngoscopy work up, if needed
- Secondary palate surgery, if needed
- Annual hearing tests
- Phase I Orthodontics 7-9 years, if needed for alveolar bone graft surgery
- Alveolar bone grafting surgery at 8-12 years, if gumline was effected by clefting
- Cleft/Craniofacial Team Panel visit
Adolescent years
- Cleft/Craniofacial Team visit
- Phase II Orthodontics
- Cleft lip scar revision, rhinoplasty, if nose was effected by clefting
- Jaw advancement surgery, if needed for best jaw relationship for chewing, speech and facial profile
