Cleft Lip and Palate: A Parent's Complete Guide

What Is Cleft Lip and Palate?

A cleft lip is an opening or split in the upper lip that occurs when the facial structures do not fuse completely during early pregnancy. A cleft palate is a similar opening in the roof of the mouth. These conditions can occur together (cleft lip and palate) or independently. Cleft lip and palate is one of the most common congenital birth defects, affecting approximately 1 in 700 births worldwide.

For parents receiving this diagnosis, it is natural to feel concerned. However, with modern surgical techniques and comprehensive care, children born with cleft conditions can achieve excellent functional and aesthetic outcomes. Dr. Prasanna Somvanshi, a board-certified plastic surgeon in Mumbai with specialised training in cleft and craniofacial surgery, provides expert care for children with cleft conditions at NH SRCC Children's Hospital and other leading hospitals.

What Causes Cleft Lip and Palate?

The exact cause of cleft lip and palate is often multifactorial, involving a combination of genetic and environmental factors:

Genetic factors – A family history of cleft increases the risk, though many cases occur without any family history.
Environmental factors – Certain medications taken during pregnancy, maternal smoking, alcohol consumption, nutritional deficiencies (particularly folic acid), and maternal diabetes have been associated with increased risk.
Syndromic clefts – In some cases, cleft lip or palate may be part of a broader genetic syndrome such as Pierre Robin sequence or Van der Woude syndrome.

It is important for parents to understand that cleft conditions are not caused by anything they did wrong during pregnancy. These are developmental variations that occur very early in foetal development.

When Should Surgery Be Performed?

The timing of cleft surgery follows well-established protocols to optimise outcomes:

Cleft lip repair – Typically performed at around 3 to 6 months of age. The procedure, called cheiloplasty, reconstructs the lip to create a natural appearance and restore muscle function.
Cleft palate repair – Usually performed between 9 to 12 months of age, before the child begins to develop speech. This procedure, called palatoplasty, closes the opening in the roof of the mouth to allow normal speech development and feeding.
Secondary procedures – Some children may require additional surgeries as they grow, including alveolar bone grafting (around age 8-10), rhinoplasty for nasal refinement, and speech-related procedures.

The Surgical Approach

Dr. Prasanna Somvanshi employs internationally recognised techniques for cleft repair. For cleft lip, the Millard rotation-advancement technique and its modern modifications are used to achieve precise lip reconstruction with minimal scarring. For cleft palate, techniques such as the Bardach two-flap palatoplasty or Furlow double-opposing Z-plasty are utilised depending on the type and extent of the cleft.

The goal of surgery is not just to close the gap but to restore normal anatomy, ensure proper muscle function for feeding and speech, and create an aesthetically pleasing result that allows the child to grow up with confidence.

Smile Train Fellowship & NH SRCC Children's Hospital

Dr. Prasanna Somvanshi is a Smile Train fellow, having received advanced training through the Smile Train programme, which is the world's largest cleft-focused organisation. This fellowship provided additional expertise in complex cleft repairs and protocols for comprehensive cleft care.

NH SRCC Children's Hospital in Mumbai is one of the premier centres for paediatric cleft and craniofacial surgery in India. The hospital offers a multidisciplinary cleft team that includes plastic surgeons, paediatricians, speech therapists, orthodontists, ENT specialists, and nutritionists – all working together to ensure the best possible outcomes for each child.

The Importance of Multidisciplinary Care

Cleft care extends far beyond surgery. Children with cleft conditions benefit from:

Speech therapy – To address speech development issues related to the palate
Orthodontic treatment – To guide dental and jaw development
ENT care – To manage ear infections and hearing concerns common in cleft children
Nutritional support – Especially in the early months when feeding can be challenging
Psychological support – To help children and families cope with the emotional aspects

A Message to Parents

If your child has been diagnosed with a cleft lip or palate, know that treatment outcomes today are excellent. With the right surgical team and comprehensive follow-up care, your child can lead a completely normal, healthy life. Dr. Prasanna Somvanshi and his team at NH SRCC Children's Hospital, Surya Hospital, and other affiliated centres in Mumbai are committed to providing compassionate, expert care for every child and family. Reach out today to schedule a consultation and take the first step towards your child's brighter future.