Conditions + Treatments

Treatments for Robin Sequence in Children

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Contact the Cleft ad Craniofacial Center

Treatment for Robin sequence ensures your baby can eat and breathe safely and comfortably.  At Boston Children’s Hospital, our dedicated and knowledgeable team of specialists from several disciplines provides you and your child with the care and expertise necessary to treat this combination of birth defects. We provide both surgical and non-surgical treatments.

Airway and Breathing Treatments for Robin Sequence

Children with Robin sequence may have trouble getting enough oxygen. This is due to glossoptosis—a tongue that is positioned further back in the mouth than normal.  Glossoptosis is caused by the smaller lower jaw that triggers this sequence.

Nonsurgical treatments to assist with breathing include:

  • Positioning: Laying your baby on his/her side or belly will help to pull the tongue forward and unblock the airway. Your child will need to be continuously monitored with an oxygen saturation monitor.
  • Nasopharyngeal airway: At Boston Children’s Hospital, our craniofacial team can insert a small, flexible tube into your child’s nose and down the throat (ending just above the vocal cords). This tube keeps the airway open by preventing the tongue from falling back and blocking it. This tube will need to be changed every few days. If your baby needs to use this tube over the long term, the size and length may need adjusting to accommodate your baby’s growth. Learn about our Craniofacial Program.

Some children may also require surgery. At Boston Children’s, potential surgical interventions include:

  • Tongue/lip adhesion (TLA)—This procedure:
    • Corrects the position of your baby’s tongue by pulling the base of the tongue forward and stitching it to the lower lip
    • Holds the tongue forward until your child develops a more stable airway with growth
    • Is reversed when your baby’s cleft palate is repaired, at approximately 9-11 months old
  • Mandibular distraction osteogenesis (MDO)—This process:
    • Lengthens the jaw in a forward direction
    • Pulls the tongue base forward
    • Relieves the obstruction of the airway
    • Involves generating new bone by progressively stretching divided segments of the jaw

Feeding Treatments for Robin Sequence

At Boston Children’s, our dedicated craniofacial nurses will weigh your child and provide frequent follow-ups to make sure you have answers to all your questions. As we monitor your child’s growth and weight gain, our team of doctors and nurses may suggest the following:

  • Specialty feeders: The Haberman feeder is the most commonly used bottle for infants with Robin sequence and/or a cleft palate. In this specially designed bottle, the nipple is separated from the bottle by a one-way valve. It helps your baby feed by rewarding even the weakest suck with formula or breast milk. It also:
    • Never floods
    • Reduces wind, vomiting and colic
    • Has variable flow settings
    • Allows to you apply compression to help your baby receive milk
  • Nasogastric feeding tube (NG tube): This is a flexible tube made of rubber that is passed through your baby’s nose and into the stomach. NG tubes are utilized as a temporary solution (weeks to months) to ensure weight gain.
  • Gastrostomy feeding tube (G-tube): A feeding tube that is inserted directly into the stomach to provide nutrition. This tube is surgically placed and is used as a long-term solution (six months to years).

Cleft Palate Repair at Boston Children’s Hospital

Your child’s cleft palate will be treated when he or she is 9-11 months old. Boston Children’s Hospital provides one of the largest cleft lip and palate programs of its kind. Our combination of specialized training, innovative treatments and compassionate, family-centered care has made us a national leader in the field. Families travel from great distances for the expertise of our Cleft Lip and Palate Program

This program can provide your child and family with:

  • Highly advanced surgical cleft palate repair
  • Dental and orthodontic treatment
  • Feeding guidance and nutritional support
  • Evaluation and management of hearing loss
  • Speech therapy
  • Psychosocial support and counseling

The type of treatment depends on the extent of the cleft and may include:

  • Dentofacial orthopedics: Repairs of the face and jaw that may require appliances in upper jaw to widen the palate or headgear to correct an underbite.
  • Corrective surgery and follow-up surgery to make additional corrections.

Learn more about our Cleft Lip and Palate Program.

Make an Appointment

For an appointment with the Cleft and Craniofacial Center, more information or to obtain a second opinion for your child, please call us at 617-355-6309 or email samantha.hall@childrens.harvard.edu.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at +01-617-355-5209.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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