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Treatment and support

Your child’s care pathway

The following is a rough timetable of what to expect whilst your child is under our care. This will be adjusted according to your child’s needs. 

If you have any queries or concerns, you can contact us at any time – you do not need to wait for the next appointment.

Contact Oxford centre | Contact Salisbury centre

Pre-birth

If you have an antenatal diagnosis, you will be referred to us and a clinical nurse specialist will be in touch within 24 hours of receiving the referral. They will be your main point of contact from this point onwards, providing antenatal support and postnatal support (including feeding your baby).

You can also meet the surgeon and clinical team if you wish – just ask your clinical nurse specialist.

Next step / milestone: 1st hospital clinic appointment when your baby is 6-8 weeks old.

6-8 weeks: 1st hospital clinic appointment

This is to discuss care of your baby’s cleft and the care pathway. It will take place at the early years clinic for your centre. See Oxford Surgical clinic or Salisbury Early Years clinic for more information.

Next step / milestone: If your baby has a cleft lip, the next step will be their cleft lip repair at approximately 4-6 months old. If your baby has a cleft palate, the next step will be their cleft palate repair at approximately 9 – 13 months old.

4-6 months: cleft lip repair

See cleft lip repair for more details.

Next step / milestone: If your baby has a cleft palate, they will have cleft palate repair surgery at approximately 9 – 13 months old.  The next step for children with an isolated cleft lip (a cleft lip without a cleft palate) is the toddler clinic at 18-24 months old.

9-13 months: cleft palate repair

See cleft palate repair for more details.

Next step / milestone: toddler clinic at 18-24 months.

18-24 months: toddler clinic

We monitor your child’s development and tooth development at this clinic.

For more information, see  Oxford Toddler clinic or Salisbury Toddler clinic.

Next step / milestone: 3 year clinical review

3 years: clinical review

This is an opportunity to review and discuss your child’s development.

It takes place at the review clinic for your centre. See Oxford Surgical clinic or Salisbury 3 Year Clinical Review clinic for more information.

Next step / milestone: 5 year clinical review.

5 years: clinical review

This is an opportunity to review and discuss your child’s development. It is also a national  audit point – outcomes recorded at this clinic are submitted anonymously to a national database for comparison of care across the UK.

It takes place at the review clinic for your centre. See Oxford 5 Year Clinical Review clinic or Salisbury 5 Year Clinical Review clinic for more information.

Next step / milestone: If your child has an alveolar cleft (a cleft of their gum), the next step will be alveolar bone graft planning and surgery at the age of 8-9 years. Otherwise, 8 year clinical review. 

8 years: clinical review (for children without alveolar clefts)

This is an opportunity to review and discuss your child’s development.

It takes place at the cleft clinic for your centre. See Oxford Paediatric Combined Cleft clinic or Salisbury Children’s clinic for more information.

8+ years: alveolar bone graft planning and surgery (for children with alveolar clefts)

We will assess your child’s jaw development and teeth eruption prior to surgery. This assessment takes place at a cleft clinic for your centre. See Oxford Paediatric Combined Cleft clinic or Salisbury Surgical Planning clinic for more information.

The timing of surgery will depend on your child’s dental development. See alveolar bone graft for more information.

Next step / milestone: 10 year clinical review

10 years: clinical review

This is an opportunity to review and discuss your child’s development. It is also a national audit point – outcomes recorded at this clinic are submitted anonymously to a national database for comparison of care across the UK. At this age we will begin to involve your child more in discussions and decision-making about treatment, with your support.

It takes place at the review clinic for your centre. See Oxford 10 Year Clinical Review clinic or Salisbury 10 Year Review clinic for more information.

Next step / milestone: 15 year clinical review. In some cases, your child may have a clinical review with the surgeon before their 15 year review; we will let you know if this is necessary.

15 years: clinical review

This is an opportunity to review and discuss your child’s development. It is also a national audit point – outcomes recorded at this clinic are submitted anonymously to a national database for comparison of care across the UK

It takes place at the review clinic for your centre. See Oxford 15 Year Clinical Review clinic or Salisbury 15 Year Clinical Review clinic for more information.

Next steps / milestone: Secondary cleft surgery  planning (if required) at the age of 16 or above. Otherwise 18-20 year clinical review.

16+ years: secondary cleft surgery

If appropriate, you will be offered a clinic appointment in order to discuss whether further cleft-related surgery – such as orthognathic (jaw) surgery or rhinoplasty – would be beneficial. This takes place at the Oxford Adult Combined Cleft clinic and the Salisbury Teens and Adults clinic.

The timings of any surgery will vary from person to person. You will be informed of these at your clinic appointments.

Next steps / milestone: 18-20 year clinical review.

18-20 years: clinical review

This is a final review to ensure treatment is complete and address any remaining questions.

It takes place at the cleft clinic for your centre. See Oxford Adult Combined Cleft clinic and Salisbury Teens and Adults clinic for more information.