Bifid Uvula and Submucous Cleft Palate

Who is the leaflet for? What is its aim?

This leaflet provides information for parents of babies born with a bifid uvula. The uvula hangs from the back of the soft palate, as shown in the first diagram. A bifid uvula is “split” or “forked” so it looks like there are two, as shown in the second diagram. A bifid uvula occurs in about 2% of the population who have no other health concerns and just happen to have a bifid uvula. While your baby is currently feeding well, a bifid uvula is sometimes associated with a submucous cleft palate which can have an impact on feeding, speech and hearing.

What is a submucous cleft palate?

A cleft palate is an opening or split in the roof of the mouth. Some cleft palates show a clearly visible gap, especially when they involve the hard palate (the front of the roof of the mouth towards the teeth) as well as the soft palate (the bit at the back of the roof of the mouth towards the throat).

However, sometimes babies are born with a ‘submucous cleft palate’ (SMCP), which means there is a cleft in the palate muscles but it is covered by the membrane inside the mouth known as the mucosa. A submucous cleft can’t usually be seen by the naked eye but can still have an impact on feeding, speech and hearing.

A baby with a bifid uvula will need monitoring to assess if the palate continues to function normally or if symptoms develop which may be suggestive of an SMCP. A submucous cleft palate may affect your baby’s feeding.

Symptoms of an SMCP can include:

• Baby not latching onto breast or not maintaining latch
• Clicking during feeds
• Fast sucking throughout feed
• Nasal regurgitation of milk during feeds
• Slow to feed - fussing
• Tiring during feeds - windy
• Unsettled
• Faltering growth

If you have any concerns with your baby’s feeding please contact the cleft team. A cleft nurse specialist will arrange to see you and your baby to assess their feeding and support you. This may involve using specialist bottles to assist with the feeding.

If you have been seen by a cleft nurse specialist and they have confirmed that feeding is progressing without concern, you will be discharged by the nursing team.

You will be called by the speech and language therapy team when your child is around 18 months of age. They will ask you some questions regarding your child’s speech. The speech therapist will then explain clearly whether your child requires any further assessment by the cleft team or can be discharged.

Contact us

Although you will be contacted by the speech and language therapy team when your child reaches 18 months of age, if you have any concerns at any time before then, please contact the cleft team from 08:00-18:00 Monday to Friday by telephone on 01223 596272.