Infants and young children have more ear infections than adults because their ears are different. Infants' eustachian tubes are shorter and more horizontal than adults' tubes, so fluid cannot drain out as easily. When fluid builds up in the middle ear, it often causes an infection and/or a hearing loss.
A cleft palate may affect the structure of the upper throat and the eustachian tubes. Children with cleft palates are therefore even more likely to have ear infections and other middle ear problems than most children.
Even very mild hearing losses can cause big problems for young children, as they are just starting to learn speech and language skills. Since children with a cleft lip and palate are at a higher risk, their hearing must be watched very closely for any problems. Some doctors prefer to insert tubes in the ears of children with a cleft lip and palate to prevent problems before they occur.
As a child with a cleft lip and palate grows older, ear problems tend to become less frequent and less severe.