Although cleft lip and palate is a single anomaly, its consequences affect several systems and functions of the child as well as the social and psychological problems that impact on the child and parents. Therefore, the services of a team of specialists are required to care for a child with cleft lip and palate. Empathic counselling and help with feeding ensures that the infant can cope with the primary surgery to the lip and palate. If speech problems occur, a nasendoscopy can be performed to determine the nature of the speech abnormality and to assess the appropriateness of additional palatal surgery. Nasendoscopy may also be required later because osteotomy surgery can compromise speech. Alignment of the teeth may be necessary before bone grafting of the residual alveolar cleft, and is always needed prior to and after orthognathic surgery. The development and regular practice of a range of clinical skills is essential if the team of specialists are to plan and deliver the appropriate high quality care needed by children and adolescents with cleft lip and palate.