Ganga Hospital in collaboration with Smile Train aims to provide holistic care to children and adults with cleft and craniofacial deformities. With our multidisciplinary team of highly qualified specialists and world class amenities, we strive to ensure quality care for our patients, completely free of cost.
1. What is a cleft lip and palate?
A cleft lip and palate is a gap or split in the upper lip, the roof of the mouth (palate) or both. It is formed when the lip and palate tissues do not fuse together during the development of the foetus.
Photograph of a 3 month old child with cleft lip and palate
2. What is a cleft lip and palate?
The causes of cleft lip and palate are largely unknown, but experts speculate that there may be multiple reasons like a genetic predisposition, nutritional status of the mother and other environmental factors. There is ongoing research to help understand the cause of this condition.
3. How common are cleft lips and palates?
The incidence of cleft varies with geographic distribution. In India, the prevalence is estimated to be around 27,000 to 33,000 clefts per year. The accumulation of unrepaired clefts of the lip and palate pose a significant health problem in India.
1. Is it possible to identify a cleft lip/palate during pregnancy?
It is possible to identify most cases of cleft lip and palate through ultrasound during pregnancy. However, a cleft palate that occurs without a cleft lip may be difficult to identify on ultrasound.
2. At what age can the cleft lip and palate be treated?
Pre-surgical treatment of cleft lip and palate can be initiated when the infant is as young as 10 days old with the help of Nasoalveolar Molding (NAM). The cartilage, skin and bone of an infant’s face is very flexible. The goal of NAM is to reduce the size of the cleft defect by moulding the tissues around the cleft using an acrylic plate that covers the roof of the child’s mouth. This helps narrow the width of the cleft, and improves the results of surgery. Additionally, the child can be fed expressed breast milk/formula without any difficulty while wearing the acrylic plate.
Photograph of a Nasoalveolar Molding (NAM) plate
Photograph of a 3 month old child with a NAM plate
1. Why does a child with cleft lip and palate need surgery?
A child with cleft lip and palate faces a multitude of problems with regard to feeding, breathing, dentition, speech and esthetics.Surgery can help alleviate these difficulties, which if left untreated, in the long term, could result in challenges like recurrent illness and malnutrition.
2. How many surgeries does a child with cleft lip and palate need?
It varies for each child. Typically, a child with both cleft lip and palate would require two surgeries initially for correcting the cleft lip and cleft palate. Following that, depending on the growth of the child, further surgeries can be planned to help improve appearance and function.
3. At what age can surgery be done for cleft lip and palate?
Surgery to correct a cleft lip can be performed when the child is around 4- 6 months of age, and a cleft palate can be operated subsequently when the child is around 9-12 months, the goal being to repair the cleft palate before 1 year of age to facilitate proper speech development. At around 9-13 years of age, alveolar bone grafting (ABG) can be done, which is a procedure where a small segment of bone is taken from the hip bone and inserted into the bony cleft of the upper jaw. After 18 years of age, when growth is complete, additional surgeries to correct the position of the jaws, improve the structure of the nose etc can be planned.
Children with clefts can seek dental treatment as soon as the primary (milk) teeth have erupted, so that the dental practitioner will be able to assess the growth status and suggest age appropriate treatment.
1. Does a child with cleft lip and palate need braces?
Children with cleft lip and palate require orthodontic support to help align the teeth and monitor the growth of the jaws. Additionally, children with clefts are more susceptible to dental problems like decay and gum disease and require periodic monitoring by qualified dental practitioners to help identify and treat these problems at an early stage.
Good nutrition is vital for the normal growth and development of a child. A qualified dietician will be able to evaluate the nutritional needs of a child and help achieve the desired weight gain prior to surgery.
1. Can a child with cleft lip and palate be breastfed?
An infant with cleft lip and palate will face difficulty while breastfeeding or bottle feeding due to their inability to suck and form an oral seal. In such situations, mothers are advised to express the breast milk and feed the infant using a syringe/spoon.
2. What is the diet for a child with cleft lip and palate?
Infants with cleft lip and palate are very susceptible to malnutrition due to challenges in breast and bottle feeding. Additionally, children with clefts may be advised to follow a liquid diet following any surgical procedure. It is important that the family consults with a trained nutrition specialist to ensure that the child obtains the required nutrients for proper growth.
1. When can a child with cleft lip and palate start speech therapy?
It is important to initiate speech therapy for children with clefts as soon as they have undergone surgical repair of the cleft palate so that the child can learn to speak with minimal articulation errors.
2. Will a child with cleft lip and palate be able to speak normally?
Children with clefts may face difficulty developing normal speech habits that may result in language delay and articulation errors. Early surgical repair of a cleft palate is vital to help facilitate proper speech. Additionally, the child may require the aid of a trained speech-language pathologist to conduct therapy that will help the child develop normal communication.
Our multidisciplinary team consists of individuals who have considerable experience in the field of cleft and craniofacial surgery and are pioneers in their specialties.
Our partner organization Smile Train is dedicated to helping children with clefts worldwide. If you would like to know more about Smile Train and their work, visit: https://www.smiletrain.org
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