Cleft Lip and Palate Repair in Sharjah
Medically reviewed by Dar Al Kamal Team
What is cleft lip and palate repair?
Cleft lip and palate repair is a series of reconstructive operations that close a gap, or cleft, in the upper lip, the palate (the roof of the mouth), or both. A cleft forms early in pregnancy, when the parts of the face that normally join in the midline stay apart. It can affect one side of the lip or both, and it can involve the gum ridge, the front bony palate and the soft palate at the back of the mouth.
Parents are often surprised to learn that cleft care is planned as a journey, with each operation timed to a stage of the child's development. The lip is usually repaired first, in the early months of life, to restore the shape of the mouth and the muscle ring around it. The palate follows, ideally before the child starts to form words, because a working soft palate is what lets speech sound clear. Some children need further, smaller operations as they grow.
At Dar Al Kamal Hospital, Sharjah, cleft repair is performed within the Plastic Surgery department by Dr. Hamid Esmaeil, Specialist General & Cosmetic Surgeon, working alongside the children's doctors of the Pediatrics and Neonatology department.
Who needs it
Cleft repair is for babies and children born with a cleft lip, a cleft palate or both. Many clefts of the lip are seen on a pregnancy scan, which gives parents time to meet the team before the birth. A cleft of the palate alone is often found at the newborn check, or when a baby has difficulty feeding.
The first priority for a newborn with a cleft is feeding and weight gain, and surgery is timed around that. The surgeon and the paediatric team look at your baby's general health, weight, breathing and any other conditions before recommending when each stage should happen. Older children and teenagers who had earlier repairs may come for a later stage, such as refining the lip scar or the shape of the nose, or closing a gap in the gum ridge before adult teeth come through. You have time to ask questions at every stage, and the plan is agreed with you.
What happens
Every stage of cleft repair is performed under general anaesthesia, with care from the paediatric anaesthesia team, so your child is asleep and comfortable throughout. A parent can usually stay with the child until they fall asleep.
For a cleft lip, the surgeon rejoins the lip muscle and carefully aligns the edge of the lip, the red part and the skin, so the mouth moves and looks balanced. The nostril on the cleft side is often reshaped at the same time. Fine stitches close the skin, and the scar is placed along the natural lines of the lip.
For a cleft palate, the surgeon works inside the mouth, bringing the tissue together in layers and repositioning the muscles of the soft palate so they can lift and close off the nose during speech and swallowing. There is no visible scar on the face from palate repair. Your child is monitored closely on the ward afterwards, and feeding restarts once they are awake and settled.
Preparing for it
Before the first operation, the aim is steady weight gain. The nursing team shows you how to feed a baby with a cleft, including special bottles and teats that make feeding easier and positions that help. Mothers who wish to breastfeed receive help from breastfeeding support, and the child's weight is checked regularly.
A pre-operative check with the paediatric team confirms your child is well enough on the day. A cold, a chest infection or a fever usually means a new date, so tell the team if your child is unwell. You receive clear fasting instructions for milk, feeds and clear fluids. Bring your child's usual feeding bottle, a favourite comforter or toy, and loose clothing that opens at the front. If the date falls in Ramadan, raise it early so the timing of your own fasting and your child's care can be planned together.
Afterwards
Most babies are comfortable with regular pain relief given by the nurses. After lip repair, the stitch line is kept clean with the method you are shown, and arm splints may be used for a short time to stop small hands reaching the mouth. After palate repair, soft or liquid food is used for a period and hard toys, straws and spoons are kept out of the mouth.
Follow-up continues through childhood. Children with a cleft palate are more prone to fluid behind the eardrum, so regular hearing tests are part of the plan, with the children's ENT team where needed. Speech is assessed as your child starts talking, and dental and orthodontic care follow as the teeth come through. In the Sharjah heat, keep your child cool and well hydrated while the wound heals.
Contact the hospital urgently if your child has a fever, the wound becomes red, swollen or starts to open, or your child refuses feeds or has fewer wet nappies. **Go to the emergency department straight away if your child has bleeding from the mouth or nose that continues, noisy or difficult breathing, or is unusually drowsy.**
Cost and insurance
Cleft lip and palate repair is reconstructive surgery that restores feeding, speech and normal growth, so most UAE insurance plans treat it as medically needed and cover it with pre-approval. Each stage is usually approved separately, supported by the surgeon's report, so the approval for a later operation is requested when that stage is planned. Some plans set their own limits on speech therapy sessions and orthodontic care. Dar Al Kamal Hospital, Sharjah can help you check your child's cover and start each approval early on 06 599 7777.
Related services
Frequently asked questions
What are the risks of cleft lip and palate repair?
Cleft lip and palate repair carries the risks of any operation in a young child, including bleeding, infection, a reaction to the anaesthetic and breathing problems in the first hours afterwards. A small hole can remain or reopen in the palate, the lip scar can thicken, and some children still need speech help or a further operation. The surgeon explains how these apply to your child before each stage.
Did something I did in pregnancy cause my baby's cleft?
A cleft usually has no single cause and in most families nothing the parents did can be identified as the reason. Genes and factors in early pregnancy both play a part. The paediatric team can talk through your family history and what it may mean for a future pregnancy.
When will my baby have cleft lip surgery?
Cleft lip repair is usually done in the early months of life, once the baby is feeding well, gaining weight and healthy enough for an anaesthetic. The exact timing depends on your baby's health and the type of cleft, and the surgeon agrees the date with you.
Can my baby breastfeed with a cleft lip or palate?
Many babies with a cleft lip alone can breastfeed, because the lip seals around the breast with some help. Babies with a cleft palate often find breastfeeding hard, as they struggle to create suction, so expressed breast milk given with a special bottle is a common choice. The nursing and breastfeeding team helps you find what works.
Will my child need more than one operation?
Most children with a cleft lip and palate have more than one operation, because the lip and palate are repaired at different ages. Some children also need later procedures to refine the lip or nose, close a gap in the gum ridge, or improve speech. The surgeon outlines the likely plan for your child and reviews it as they grow.
Will my child's speech be normal after palate repair?
Many children develop clear speech after palate repair, while others need speech therapy or, sometimes, a further operation to help the soft palate close properly. Speech is assessed regularly as your child learns to talk, so any need for extra help is picked up early.
Will there be a scar after cleft lip repair?
Cleft lip repair leaves a scar on the upper lip, which the surgeon places along the natural lines of the lip so it blends in. The scar is usually red at first and fades and softens over time. If it becomes noticeable as your child grows, a revision can be discussed.
Is cleft repair covered by insurance in the UAE?
Cleft repair is reconstructive surgery and is usually covered by UAE insurance plans with pre-approval for each stage. Some plans limit related care such as speech therapy or orthodontics. Contact the hospital to check your child's policy before each planned stage.
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