A cleft palate is a hole in either the hard and/or soft palate due to failure of these structures to fuse in the midline during fetal growth. This hole creates a connection (fistula) between the nose and mouth, allowing food to regurgitate through the nose, making feeding at times difficult. Specialty bottles and nipples are available to help your child feed normally prior to surgical repair (1 year of age). Surgical repair is delayed until one year to allow your child to grow, allowing a better chance of a successful repair. Most importantly, during the surgery, the muscle (levator palatini) is repaired, allowing for normal speech by sealing off the nose from the mouth during muscle contraction. Statistically, up to 20% of children require a secondary procedure to improve speech, when this muscle fails to work properly even after repair (VPI).