- 6 min read
Twenty-two and just graduated from university, Ruby Davie has a bright future ahead of her. She is confident and quick to smile, but it has not always been that way.
Born with a cleft lip and palate, during her childhood and into early adulthood, Ruby faced challenges eating, drinking and speaking. She underwent the first of what would be 7 surgeries at 6 months of age.
Her final operation in September 2024 had a profound impact on her physical and emotional well-being.
‘Before the surgery, I was struggling with speaking, eating, and drinking. It gave me immense anxiety and isolated me quite a bit,’ shared Ruby.
‘Six months after the surgery I went on holiday and for the first time in my life I smiled in every single photo! I can look back and love how I look in those photos. It was a really big moment for me.’
‘The team (at Monash Health) not only changed my face and my speech, but how I feel about myself, which is incredible.’
For Ruby and her parents, the end of her 22-year-long care journey is marked with joy, relief, and gratitude.
‘Modern cleft care has come a long way and the results are truly remarkable!’ shared Ruby’s mum, Leanne Davie.
Multi-phase treatment
In Australia, around 1 in every 700 children is born with a cleft.
The treatment journey for a cleft lip and palate is long, typically involving multiple surgeries into a patient’s late teens or early adulthood, as well as speech therapy and orthodontics.
Throughout her journey, Ruby and her parents have been supported by a team of multidisciplinary specialists at Monash Health – first at Monash Children’s Hospital, and later at Monash Medical Centre in Clayton and Dandenong Hospital.
‘The beauty of Monash Health is that we can smoothly transition care from Monash Children’s Hospital to our adult system,’ said Nelson Low, Head of Paediatric Plastic Surgery and Research at Monash Health.
‘We see parents after their 20-week ultrasound scan for an antenatal consult, and patients from newborn to adulthood. They have continuity of care, which makes it a lot easier for them, especially during the transition period to adulthood.’
A defining journey
While cleft lips may be detected during routine ultrasound during pregnancy these days, Ruby’s parents did not learn of the split in their daughter’s upper lip and the split in the roof of her mouth until she was born in 2004.
Ruby’s mum recalls the first appointment they had with a plastic surgeon at Monash Children’s Hospital, when her daughter was 5 weeks old.
‘I remember the doctor telling my husband and I that they don’t know why clefts occur, but what they do know is that for some reason, these children grow into the most beautiful, empathetic human beings. And they believe it is because they endure so much throughout their little lives,’ said Leanne.
‘Twenty-two years later, he could not have been more right! Ruby has empathy beyond her years. I am immensely proud of her.’
Eager to help others, in her childhood, Ruby fundraised for the not-for-profit volunteer organisation, CleftPALS Victoria.
‘I used to raise money at school and sell fruit out the front of my house and send it off, because they would put funds to kids in other countries that couldn’t afford to have the care that I had growing up.’
Her contact with the medical community has not only impacted her health; it has also set the direction of her career.
‘Being involved with health professionals all my life sparked my interest. I definitely knew that I wanted to work in the health field,’ said Ruby.
Recently graduated in Occupational Therapy from Federation University in Churchill, Ruby is working in a paediatric clinic and in public community health.
‘It’s been a long journey, sometimes really tough. To anyone on a cleft journey, I would say try and stay optimistic, keep persevering. There is light at the end of the tunnel.’
On-going care
Ruby’s first operations at 6 and 9 months old were a lip repair and palate repair with the Plastic Surgery team.
‘My mum had a lot of difficulty feeding me, the milk would just come straight out of my nose. The main purpose of the surgeries was to assist with feeding and ensuring that I had the right nutrients.’
In Grade 5, maxillofacial surgeons took a bone graft from Ruby’s leg to fill a gap in her gum, to help a tooth come down.
‘I grew up with only one front tooth because of my cleft lip and palate. Throughout my childhood and teen years, people made lots of comments and jokes about it, which had an impact on my self-love and confidence.’
When the tooth did come down, it was severely rotated, and Ruby began years of orthodontic treatment.
Having reached adulthood and her growth at an end, 3 years ago, Ruby underwent double jaw surgery with the maxillofacial team. Her upper jaw was moved forward, and her lower jaw back. The operation aligned her jaws and corrected her bite. However, it created a larger hole in the back of her mouth, between the back of her throat and soft palate.
‘We were warned it might happen. It meant that a lot of air was escaping out my nose when I was speaking, eating and drinking.’
‘People couldn’t understand me saying my name, to the point where, if I was with shopkeepers, they would ask me to write my name down because they couldn’t understand me. I used to avoid making orders on the phone or going out in public and talking to people.’
In September 2024, plastic surgeon Nelson Low operated to lengthen her soft palate.
‘Nelson helped me regain my confidence when I was in a time where I thought I was never going to get that back,’ said Ruby.
‘We will be forever grateful to Nelson for his incredible surgical skills and giving Ruby her speech back!’ said Leanne.
A dedicated clinic
Monash Children’s Hospital’s Cleft and Craniofacial Anomalies Service clinic, held twice a month, provides patients with access to speech pathologists, plastic surgeons, oral maxillofacial surgeons, dentists, orthodontists, ear, nose and throat surgeons, audiologists, and a care coordinator at one hospital visit.
A genetics service is also available at the adjoining Monash Medical Centre.
Paediatric speech pathologist Janella Christie has been part of the multi-disciplinary team caring for Ruby from the start.
‘I first met Ruby when she was about 8 weeks of age, when her mum was having trouble feeding her with a regular bottle and teat, and I saw her for review at various age milestones,’ said Janella, a Senior Clinician at the clinic.
‘As a therapist, it’s amazing establishing a relationship with the parents and with the child over many years.’
‘I’m delighted that Ruby’s experience of Allied Health has steered her into an occupational therapy career pathway!’
On the day Ruby had her braces taken off, she presented the service’s Consultant Orthodontist, Jeff Lipshatz, with a heartfelt thank you letter, stating he had ‘gifted’ her ‘a whole new sense of confidence that I have never felt in my life’.
‘It was my privilege to treat Ruby,’ said Mr Lipshatz.
‘It gives me immense satisfaction that I was part of the team that helped create her beautiful smile and that she now has the self-confidence to pursue her dreams and aspirations. That is what it is all about.’
Shine Gala
The 2026 Monash Children’s Hospital Shine Gala raised funds to support the impactful work of the Cleft and Craniofacial Anomalies Service.
You can still donate via the Monash Health Foundation website.
