What Parents Need to Know About Cleft Palate Repair

What is cleft palate?

Cleft lip and cleft palate are craniofacial anomalies of the mouth and lip that occur early in utero when the sides of the lip and the roof of the mouth do not fuse together as they should. A child can have cleft lip or a cleft palate, or both. A cleft palate leaves an opening in the mouth that also affects the normal positioning of the muscles that we use for speech and swallowing.

Treating Cleft Palate

Several specialists including nurses; ear, nose and throat doctors; speech and hearing specialists; geneticists and surgeons work together to address issues of proper feeding and nutrition, hearing and language development, and restoration of normal function and appearance.  We are very fortunate that the current treatment of cleft palate is very effective and offers children full functional restoration. It’s very enjoyable to be a cleft surgeon because cleft palate is readily treated with surgery and you can make a lifelong difference in the life of a child and their family.

Complications for Baby

An infant with a cleft palate may have a hard time sucking properly because the roof of the mouth is not formed completely, making eating difficult. Ear infections are also common due to a dysfunction of the tube that connects the middle ear and the throat. In addition, a child with cleft palate may have speech and language delays. The most immediate concern is that your baby gets good nutrition.

Feeding an Infant with Cleft Palate

This can be challenging. Breast-feeding may not be a realistic way to feed an infant with a cleft palate, but pumping breast milk and using a specialized bottle is an alternative. Here are some tips:

• Hold the baby upright to help keep the food from coming out of the nose.
• Small, frequent feedings are best.
• Ask a feeding therapist familiar with feeding children with cleft palate or contact the craniofacial team to recommend types of nipples that will work best for the baby.
• Ask about extra calorie supplements you can add to breast milk or formula if needed.

Fast Facts

• Babies born with cleft lip or palate: 1 in 500 — 1 in 2000
• Age range that is best to surgically fix a cleft palate: 9 – 12 months
• Age range that is best to surgically fix a cleft lip: 3 – 6 months

Dr. Toranto completed residencies in general surgery at the University of Alabama at Birmingham and in plastic surgery at Duke University Medical Center. He completed a craniofacial surgery fellowship at Children’s Hospital of Los Angeles. During his residency, Dr. Toranto was selected as a Regan Fellow with the nonprofit organization Operation Smile and participated on a mission to India where the physicians treated more than 100 cleft children.

Dr. Toranto’s philosophy of care: “I want to take care of hte patients and their families to the best of my ability.”

Education:
Universy of Michigan School of Medicine, Ann Arbor, Michigan
Bachelor of Science in Biological Sciences from Stanford University in California

Board Certifications:
Surgery

CHOC is the only hospital in Orange County to offer comprehensive treatment and surgery for patients with Pierre Robin Sequence, a facial condition that can limit breathing in infants.

Pierre Robin Sequence is a birth condition wherein a baby has a small jaw and a small, receding chin. As a result, the tongue tends to be displaced back toward the throat, where it can fall back, block the airway and cause difficulty breathing.