Prenatal consult

At the Cleft Palate Center at Providence Saint John's Health Center, cleft care can begin before your baby is born. With current advances in ultrasound, many families find out the baby they are expecting has a cleft. This is an opportunity for the parents to meet members of the team and to feel better prepared to begin care when their baby is born.

Cleft causes and diagnosis – genetics and cleft
The exact cause of a cleft is still unknown. A genetics evaluation may assist in obtaining a complete diagnosis and recurrence rate for a particular individual and family. Our specialists can have a prenatal consultation with you.

Naso-alveolar molding

This technique has been available at Saint John's since 1993, one of the first centers to offer the technique. This treatment can be started in the newborn nursery or as soon as possible at the Cleft Palate Center.

Neonatal nasal alveolar molding
Nasal shape differences are common in people who are born with a cleft. In years past, the standard of care was to do little to the nose at the time of infant lip repair because of concerns of disturbing nasal growth. Left untreated, the resultant nasal difference was often quite severe and difficult for the affected child.

Fortunately research studies revealed surgical correction of the nose at the time of infant lip repair did not harm growth and the resultant nasal difference was much milder. Further research revealed that the infant cartilage can be molded during the first six weeks of life.

Cartilage molding has been used to correct external ear irregularities for several years.  This technique has also been applied to children with cleft lip, to influence the shape of their nose prior to the initial surgery. This further improves nasal shape and alveolar position.

A range of molding techniques is used depending on the extent of the cleft. A prefabricated conformer held with special tape is often effective. Sometimes custom appliances are made in conjunction with an orthodontic type retainer.


Our nurse coordinator/feeding specialist is available for consultation to help establish effective feeding so your baby can have a healthy start and be ready to begin surgical reconstruction.

Tips to establish effective feeding:

  • Nursing may be possible if cleft of the lip only
  • Cleft palate, even if incomplete, can interfere with creating adequate suction needed for breast feeding
  • Encourage pumping to provide breast milk
  • Squeezable bottle, cross-cut nipple
  • Upright position, frequent burping
  • Feeding diary - how much, how often
  • Frequent weight checks to ensure adequate weight gain

For more information about The Cleft Palate Center, please call 310-829-8150 or e-mail cleftpalatecenter@providence.org. Our office hours are Monday  to Friday, 8 a.m. – 5 p.m. and we are located at 2121 Santa Monica Boulevard, Santa Monica, CA 90404.
The Cleft Palate Center at Saint John's Health Center is an American Cleft Palate-Craniofacial Association Affiliated Team