Some times we see children born with a broken upper lip, called cleft lip. A few other children have a cleft of both the upper lip as well as the palate underneath, called cleft lip and palate. Lakhs of children are born with this defect in India , approximately one in seven hundred births. Though this can be corrected even in infancy with a simple plastic surgery, 50% of the parents do not know about the treatment and 75% of the children do not get it and suffer speech, teeth and eating problems.
A great majority of clefts arise for no good reason at all. In 10% of patients there is a family history of clefts. One should not believe that it is caused by exposure to eclipse or bad omen or due to certain food or fruit. It is polygenic involvement and no single gene has been found responsible.The majority of clefts appear due to a combination of inherited factors (genes) probably interacting with certain "environment" factors. It occurs in first 8 weeks of conception, that means that before even lady realises that she is pregnant, cleft is already there!
The problem with such a child begins minutes after birth. How to feed. Because of the cleft, sucking becomes difficult and with a cleft of the palate as well, the liquid could spill out of the nose. There is no best method to feed the babyThis is nothing to be concerned about. Simply wipe it away and continue feeding. Breast feeding is possible and is also the best. Babies with cleft palate may not be able to suck enough. Just supplement it with bottle or spoon feeding. Bottle feeding is good if good hygiene and sterility of the bottle and nipple is ensured. If not spoon feeding is a good method. Both methods are best used with the baby in a fairly upright posture, resting on mother's arm.
Surgery is the only way a cleft lip or cleft lip and palate can be repaired. Cleft lip can be set right when the child is three to six months old. Cleft palate repair is normally carried out between nine and eighteen months of age. If the child is older than two years , the order of operations may be changed and palate repair done first. The child is kept in hospital for about three to five days only.
A child with cleft is prone to ear infections and fluid collection in the ear. Ear discharge is common and should be treated early. Many children develop normal speech after the operation. However, 15% of children still have speech problems after the palate repair. Speech and language therapist are involved from an early stage and will monitor speech and language development. After four to five years of age , after operation and speech therapy, if the child still has speech problem, another operation can be done to improve the speech.
The growth and development of the teeth begin immediately after child birth. For any rectification of defects, Pedodontist and Orthodontist, who are specialist dentists are involved. Orthodontist treatment is needed after the permanent teeth erupt into the mouth. These will be checked and straightened as necessary. Treatment with braces may start at about seven years. If there is a defect in the gum it will be corrected by surgery at the age of seven to nine years.

So if your child or any one you know of, requires treatment for cleft lip or cleft lip and palate, act now and get relief.

Plan for the Treatment

After birth First consultation with parents, feeding advice and follow up for weight gain
1) 3 - 5months(weight 5Kg) Cleft lip repair with nose correction.

2) 9 - 12months Cleft palate repair.

3) 1 - 2 years Hearing check-up to rule out middle ear collection to prevent infection.

4) 2 - 4 years Close watch on the development of speech therapy. Regular dental check-up with pediatric dentist.

5) 4 - 6 years Surgery for speech improvement which is necessary in 10 - 15% of children after palate operation.

6) 6-12 years Dental check-up and orthodontic treatment, if necessary, bone graft for the defect in alveolus at 9 years.

7) Teenage years Correction of nose shape if patients demand and surgery to improve face.

8) Adult Genetic counseling to reduce inheritance of the defect.