Introduction
A cleft lip or a cleft palate happens when a baby is born with a split in the upper lip or roof of the mouth. It is a malformation which occurs very early during pregnancy. Cleft lip or palate occurs when during the formation of the foetus there are not enough tissues to join the parts together properly. Cleft lip appears as a narrow split on the upper lip and may occur on just one or both the sides of upper lip. Whereas a cleft palate is the opening in the roof of the mouth (palate).
Causes
In India, one out of thousand children are estimated to be born with a cleft lip or a cleft palate. The definite cause is not yet discovered. Certain evidences in the last few years have shown that the poor levels of vitamin B and folic acid in pregnant ladies are the contributing factors towards the cleft palate. Consumption of vitamins before conception can help in eradication of these facial and oral deformities. But since the cleft fusion happens between three to six months of pregnancy and most women are not aware of their pregnancies till the second month the damage cannot be reversed. Research also suggests that cleft lip and palate can occur due to the genetic and environmental factors.
Another probable cause can be the medicines consumed during the pregnancy. Certain drugs like anti- seizure drugs, methotrexate, commonly used for the treatment of psoriasis and arthritis, acne treating drugs containing accutane can cause the cleft lip.
Diagnosis
Cleft palates are hard to be diagnosed in the pre- natal stage, especially if it is without a cleft lip. Cleft palate is usually found when the mouth of the new born is examined by the doctors. Pre- natal ultrasound can sometimes detect the cleft lip in the foetus.
Complications
Babies born with cleft lip or palate face some complications regarding:
- Feeding
- Growth and development
- Ear infections and hearing
- Speech development
- Dental problems
Cleft Lip Repair
At three months a plastic surgery called cheiloplasty is carried out to repair the cleft lip. It is done to close the opening and improve the shape of the upper lip and nose. If there is a wide opening in the cleft lip, procedures like nasoalveolar molding (NAM) or lip adhesion are carried out to bring the separated sides of the lip closer and improve the shape of the nose before the repair.
Cleft Palate Repair
A plastic surgery called palatoplasty is done when the baby is about one year old to repair the cleft palate. The cleft palate is closed in layers, the muscles of the soft palate is repaired. Two incisions are made on each side of the palate behind the gums to relieve the tension on the palate repair.
After the surgery the baby is kept on the liquid diet for about two weeks, and then fed on soft foods for few weeks. Special care should be taken so that the baby doesn’t put fingers or any object inside the mouth when the stitches have not yet healed. Most children with cleft lip and palate are operated successfully by the experienced team of doctors with no permanent problems in future. Such surgeries have greatly improved in recent years. Though babies should also be kept in supervision and doctors should be consulted even after the surgery for preventing any complications.
