Cleft lip & palate are birth deformities which might occur in a newborn due to various factors including genetic and Folic acid deficiency in the mother during pregnancy. In addition to having a cosmetic deformity the babies with cleft palate also have functional deficits. The baby cannot suckle and hence breast feeding in babies with cleft palate is not possible. However breast milk can be expressed out with the hand or using a breast pump available commercially and the babies can be fed with either spoon and bowl or with special feeding bottles. The babies are also more prone to repeated cold and cough due to continuous drying of the mouth and throat as it is exposed to the external environment. Vitamin supplementation can be added for weight gain in accordance with the paediatrician. A cleft deformity not only affects the baby but the entire family psychologically. Dr. Nisheet Agni not only surgically corrects these deformities but also counsels such parents and helps them overcome their anxieties and get back to normalcy.
Ideal age for surgical repair of the cleft lip (Cheiloplasty) is around 3 months with the baby attaining 5 kg weight and having a haemoglobin level of around 10gm%. The cleft palate repair (Palatoplasty) is performed around 9 months age. Although there is no minimal weight requirement, it is preferable to have a haemoglobin level of 10gm%. The cleft palate surgery should preferably be performed before 18 months of age as the child starts speaking by then. Late surgery can predispose the baby to having a faulty speech. Dr. Nisheet Agni regularly operates on such babies and helps them and their family lead a normal life.
The cleft palate repair is followed by speech therapy after the age of around 2 years by a Speech & Language Pathologist who is specially trained in managing cleft speech.
The cleft in the gums is managed around the age of 8-10 years by grafting bone from the hip into the cleft in the upper jaw so that the permanent teeth can erupt into this grafted bone.
Rarely the repaired cleft lip or palate might have some deformity or scar or a residual hole in the palate which might need revision surgery. Dr Nisheet Agni is trained in managing these secondary deformities successfully and sees patients from far off places who come for corrective surgery after previous failed procedures.