A split lip and palate seen in some newborn children is a birth defect. The upper part of the mouth being slit is not just visually displeasing but a medical condition. It is difficult for the child to breathe, speak, swallow and eat. Medically termed as cleft lip and palate deformity, it is challenging for both the affected child and parents.
“In a cleft lip, the right and the left side of the mouth are not fully developed, leaving a gap in between the lips,” explains Dr Krisha Rao, HOD & Sr Consultant, Craniofacial & Aesthetic Surgeon, BGS Gleneagles Global Hospital, Bengaluru.
Cleft lip and palate in children are different
Cleft lip and cleft palate are two different conditions, he says, adding that when this gap extends to the roof of the mouth or the palate, it becomes a cleft palate.
When Beena Dady, delivered her daughter 11 years ago, she was shocked to see the split lip. On examination, it was found that her child Elga had both cleft and palate. “It was hard to digest and I was worried about my baby,” Dady said.
However, all hope was not lost, as doctors assured her that cleft lip and palate can be surgically treated and restored. After undergoing cleft lip and correction treatments, Elga has now become a popular singer. “Videos of her singing became viral online as people were astounded to see a girl born with cleft lip and palate could sing,” Dady says.
Why does a cleft palate or cleft lip occur?
Elga’s deformity was traced to genetics as a couple of her paternal family members were born with cleft lip and palate. “She is part of the third generation in her family who was born with a cleft lip or palate,” Dady explains.
Despite not having a definite reason why cleft lip and palate manifests, Dr PV Narayanan, Chief Surgeon, at Jubilee Mission Hospital, Thrissur, Kerala, explains that genetics and nutritional factors can contribute to a cleft lip or palate in a child. “Some families may have genetics that might have some anomalies or syndromes that need to be identified,” he explains.
Health risks of cleft lip and palate
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Malnourishment
“Breastfeeding becomes challenging for the mother because when their baby attempts to suck the milk, the air escapes from the roof of the mouth and through the nose,” explains Dr Narayanan. This often leaves the child feeling tired or gagging. “The child will not gain adequate weight if the deformity is not treated earlier.” However, this is treated by using feeding devices specially designed for cleft lip and palate. “NAM (nasoalveolar moulding) is a device that we use for infants during the time of feeding them. It is possible to treat the child to prepare them for surgery,” says Dr Rao.
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Hearing loss
“The middle ear of babies born with cleft palates is affected. The palate regulates the middle ear’s air pressure and allows secretions to drain out. When this is disrupted it causes glue ears in babies,” explains Dr Rao. “Glue ears refers to accumulation of fluids in the middle ear. This can be drained out, if the treatment is done on time.”
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Upper respiratory problems
They are prone to developing respiratory issues as well. “Some of the cleft children have repeated chest infections. They are unable to swallow food properly, due to which the food enters the lungs leading to aspiration pneumonia,” Dr Rao.
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Speech problems
Doctors also stress that they may face persistent speech problems as air escapes through the nose, which makes their speech unclear. “In schools, children with cleft lip or palate are ridiculed by their peers, affecting them psychologically as well,” says Dr Narayanan.
When should cleft lip and palate be treated?
It is ideal that the intervention for the cleft lip and palate is around three months after birth. “The first surgery must take place between three to six months when the lip and the nose are operated on. The palate is operated on after ten months,” explains Dr Rao. He explains that once the child reaches adolescence, they will undergo bone-grafting surgery. “It is an orthodontic treatment wherein the bone is operated to the gum so that the alignment of the teeth is not jeopardised,” explains Dr Narayanan.
In addition to this, the child will also be sent for speech therapy, to correct their speech.
Can cleft lip and palate be prevented?
“There is no definite research or science that says cleft lip can be prevented. However, the number of cleft lip and palate babies can be reduced by improving women’s health, even prior to pregnancy,” advises Dr Rao. He insists on following a balanced and nutritious diet, once they’ve reached the age of maturation.
Takeaways
- Cleft lips occur when both sides of the lips do not develop properly, leaving a gap between them. A cleft palate is a cavity or a gap in the roof of the mouth.
- The deformity is caused by genetics and nutritional deficiency factors.
- The deformity can be surgically treated and the ideal age for the surgery is three months after the baby is born.
