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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. “Most kids have both,” says Dr. Jason Toranto, a plastic surgeon and craniofacial specialist at CHOC. “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,” says Dr. Toranto. “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, Dr. Toranto says. In addition, a child with cleft palate may have speech and language delays. “The most immediate concern is that your baby gets good nutrition,” he says.

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

Meet Dr. Toranto - CHOC Plastic Surgeon

Dr. Jason Toranto is an assistant professor and co-director of Research at the Aesthetic and Plastic Surgery Institute at UC Irvine. 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 the patients and their families to the best of my ability.”

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

BOARD CERTIFICATIONS:
Surgery
Plastic Surgery

Jason Toranto

CHOC Operating Rooms Integrate Tech for Better Outcomes

In the operating room of CHOC Children’s new Bill Holmes Tower, technology helps equipment work together to ensure the best outcomes for young patients.

Using the technology integration system iSuite by Stryker, CHOC is the first children’s hospital in the region to have a fully integrated operating room. With more than 1,000 presets for individual doctors or disciplines, the system can also control the ambient lights, laproscopic camera and music.

Tips for Feeding Babies with Cleft Palates

Dr. Jason Toranto, a CHOC plastic surgeon and craniofacial specialist, and Sharon Vargas, a case manager and nurse specialist, recently stopped by Seacrest Studios to discuss the challenges of feeding infants with cleft palates.

Many malformations or injuries – even the most complex – can be repaired, allowing children to enjoy a normal, healthy future. The pediatric plastic surgery team at CHOC is here to expertly guide patients and their families through every stage of treatment and healing. Learn more at www.choc.org/surgery.

Understanding Pierre Robin Sequence in Babies

CHOC Children’s 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.

health-vaccines-post

Knowledge is the best medicine. Learn more about your child's health in these features from the experts at CHOC.

Kids and Electronic Health Records
An electronic health record (EHR) is a computerized collection of a patient's health records. It includes information such as age, health history, and more.


Kids and the Immune System
Our immune system is a series of cells, tissues and organs that protects us from invading pathogens and keeps us healthy and able to resist infections.


Kids and Ear Infections
An ear infection is an acute inflammation of the middle ear caused by fluid and bacteria behind the eardrum. These ear infections cause a great deal of pain.


The experts at CHOC Children’s and CHOC Children’s at Mission Hospital in partnership with the Orange County Register have developed this site to provide you with the information you need to help keep your children healthy. From immunizations to broken bones, we’re here to provide answers to some of parenting’s most common, and not-so-common, questions.

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UC Irvine

CHOC Children's is affiliated with the UC Irvine School of Medicine