01

In this article

  • A cleft can exist even when the lip looks normal
  • Middle-ear fluid is common
  • Long-term multidisciplinary follow-up is needed
02

Assessment and treatment

  • Special feeding technique or equipment
  • Palate repair at the planned stage
  • Hearing tests, ear care and speech therapy
QUICK FACTS

At a glance

Definition: A gap in the roof of the mouth can affect feeding, middle-ear fluid, hearing and speech development.

Key takeaways

  • A cleft can exist even when the lip looks normal
  • Middle-ear fluid is common
  • Long-term multidisciplinary follow-up is needed

Clinical steps

  1. Special feeding technique or equipment
  2. Palate repair at the planned stage
  3. Hearing tests, ear care and speech therapy

Red flags: Breathing difficulty, blue colour or inadequate intake during feeds needs urgent paediatric assessment.

Quick FAQ: When should I see an ENT specialist?

Breathing difficulty, blue colour or inadequate intake during feeds needs urgent paediatric assessment.

EXPERT INSIGHT

How I assess this in clinic

I first clarify duration, severity, whether symptoms are one-sided or bilateral, and their effect on daily life. I then perform a focused ENT examination and compare the findings with a cleft can exist even when the lip looks normal.

Endoscopy or audiometry is not required for everyone. I advise endoscopy when the nose, sinus, throat or voice box needs direct assessment, and audiometry/tympanometry when hearing or middle-ear function is in question.

A common misconception is that every ENT problem needs an antibiotic or an operation. Treatment should instead follow the diagnosis, functional impact, examination findings and evidence-based indications.

Do not wait when: Breathing difficulty, blue colour or inadequate intake during feeds needs urgent paediatric assessment.

ReferencesCleft lip and palateNHSYour Baby’s Hearing ScreeningNIH/NIDCDChildren and ColdsAmerican Academy of Pediatrics

For patient education; not a substitute for individual diagnosis or treatment.