Clefts of the lip and palate are congenital anomalies in children and the surgery or repair is recommended at early stages of infancy to help them lead a normal childhood.

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Cleft Lip and Palate – The
Condition and Its Treatment
Cleft lip and palate are facial and oral
malformations that happen
very early during pregnancy,
that is, when the baby is
developing in the mother’s
body. These conditions can
occur independently or together. Clefting
occurs when the tissue that makes up the lip
fails to join properly before the child is born.
The defect appears as a narrow gap or a large
opening that goes through the lip into the
nose. The split in the lip can occur on both
sides of the lip and rarely, in the middle of the
lip. When the split occurs in the roof of the
mouth, it called a cleft palate. In some cases,
both the front and back portions of the palate
are open, while in others, only part of the
palate is open.
Causes
It is believed that a combination of genetic and
environmental conditions could be responsible
cleft lip and cleft palate, though the specific
factors for the problem remain largely

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unknown. According to the Centers for Disease
Control and Prevention (CDC), research studies
point out that factors such as smoking,
diabetes and the use of medication to epilepsy
during the 3 months of pregnancy can increase
the chances of a baby being born with an
orofacial cleft.
Overcoming Problems Associated with
Cleft Lip and Palate
• Difficulty in feeding: The opening in the
palate may cause difficulty in feeding as
food and liquids can pass from mouth to
the nose. An artificial palates and specially
designed baby bottles and nipples are used
to overcome the problem.
• Hearing Loss and Ear Infections: As there
are chances of fluid build-up in the middle
ear, infants with the condition are at the
risk of ear infections. If not addressed,
these infections can affect hearing
capacity. Special tubes are placed in the
eardrums to drain the fluid.
• Difficulty in Speaking: Normal speech is
affected in most cases. A nasal tone may
interrupt the clarity of speech and make it
difficult for others to understand the
communication. More than half of children

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affected by this congenital defect require
speech therapy.
• Dental Problems: Children with cleft palate
are susceptible to dental problems such as
malformed, missing, or displaced teeth. A
defect in the alveolar ridge (the bone that
supports the teeth) could occur which
would displace, tip, or rotate permanent
teeth and prevent permanent teeth from
appearing. These issues can be set right
with surgery.
Diagnosis and Treatment
Cleft lip and palate, whether present together
or independently, are usually diagnosed during
pregnancy using ultrasound. They can also be
diagnosed after the child is born, though some
types of cleft palate would be diagnosed only
at a much later stage in life. A plastic surgeon
specialized in craniofacial surgery can provide
the right treatment for cleft lip palate.
Cleft lip surgery is usually performed when the
child is two to three months old and the nature
of the procedures and the number of
procedures required would depend on the
extent of the cleft, the amount of lip and skin
tissue present. Cleft palate surgery is advised

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within the first 18 months after birth or if
possible, earlier.
A cutting edge technique, Nasal Alveolar
Molding (NAM) is a pre-operative adjustment
that is performed to optimize the results of
surgery for orofacial clefts. The procedure
• Realigns the cleft segments of the upper
jaw
• Brings the edges of the cleft lip in closer
proximity for greater accuracy
• Initiates correction of the nasal deformity
to allow for a more normal looking nose
Cleft palate repair is a lengthy process and the
duration may vary depending the correction
required
• An upper jaw mold is created using
maxillary impressions
• The mold is used to construct an acrylic
plate
• The plate is fitted in the mouth and
adjusted on a weekly basis to correctly
align the growing bone
• Lip alignment and nasal correction

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• A stent is placed that extends to nostril,
with weekly modifications for nasal tip
elevation
• The lining of nose is stretched
Additional surgeries, dental and orthodontic
care, and speech therapy may be required as
the child grows older.