Q: What is a Cleft Lip? 
A: A cleft is termed as an opening occurring in the mouth’s roof, lip opening, or in the soft tissue present in the mouth’s back. A cleft lip is usually observed in the lip opening which can be accompanied with a separation in the bones of the upper gum or upper jaw. A cleft lip can be seen occurring on a single side or on both sides. Sometimes a cleft lip can be seen along with a cleft palate as well. 

Q: What are the causes of Cleft Lip and Cleft Palate?
A: Mostly unknown, but it can be due to genetic and environmental factors. This condition can also occur due to exposure of viruses or chemicals when the baby is in the womb. Chemicals such as anti-seizure or anticonvulsants, drugs for cancer, arthritis, psoriasis-like accutane or methotrexate which is commonly used may cause this condition.

Q: What are the demographic details of Cleft Lips?
A: Cleft lips are observed in one birth among every 500 to 700 births. The ratio may differ according to the ethnic groupings or geographical areas. The study was conducted by the World Health Organization International Collaborative Research on Craniofacial Anomalies. 

Q: What are the problems associated with Cleft Lip and Palate?
A: The various problems associated are:

• Eating problems: With an opening or split in the palate, food and liquids can pass from the mouth back through the nose. Feeding and swallowing problems are experienced by such patients.
• Speech problems: With an opening or split in the palate, the patient has speech problems. There is a delay in speaking or the child may speak abnormally.
• Chronic Infection in ears/Loss of Hearing: The tube connecting the throat and the middle ear becomes dysfunctional due to which there are chronic infections that affects hearing and may lead to hearing loss.  
• Dental Issues: Normal eruption of teeth is affected due to Cleft Lip and Palate and orthodontic treatment may be required. 

Q: Is it possible to prevent clefting?
A: Researchers are trying to find out ways in which cleft lips can be prevented. One research finding showed that if mothers consume multivitamins that contain folic acid before she conceives a baby till the second month of pregnancy, the risk of having a cleft lip in a baby will be reduced. 

Q: Is it possible to repair cleft lips?
A: It is absolutely possible to repair a cleft lip. Surgery has shown extremely good results. The plastic surgeon will work along with the patients to determine the best timing of the surgery. Most surgeons will want to conduct the surgery when the baby is about 3 months old. To conduct a surgical procedure, the child’s general health must also be considered along with the cleft lip’s nature. 

Q: When do we have to be in the hospital?
A: A letter will be provided with the pre-operation assessment. The operation date and timings will also be mentioned in it. Before the operation, you will also receive a call to ensure that you arrive in time and you get sufficient amount of drinks and food when coming to the hospital. 

Q: How will the operation be?
A: The timings will significantly vary depending on the type of operation that is to be conducted. The team will be able to answer this question better when you will be briefed about the operation. The operating time will be lesser than the time the baby has to be away from parents. 

Q: Will the parents be allowed to stay with their child when under general anesthesia? 
A: Both the parents will be allowed to come along to the anesthetic room but will be asked to leave when the child is under general anesthesia. 

Q: What options will be provided for pain relief to the patient?
A: This will depend on the operation and the resistance to any drug. Usually, paracetamol, ibuprofen, and morphine can be provided to the patient. 

Q: What is the recovery time for cleft lip surgery?
A: The babies will undergo close monitoring after the surgery is done for a few days. The recovery will include special care for a few weeks. However, the hands will be restricted to make sure that the child doesn’t disrupt the surgical repair.

Q: What kind of follow up will be necessary after cleft lip surgery?
A: It is important for the family to be there for the follow-ups as suggested by the surgeon to make sure that the healing process is in progress. It will usually be a few sessions. But, in case of complications, the sessions might be increased. It is important to stay in close contact with the surgeon after the surgery. 

Q: Will the child undergo MRI / CT Scan before the surgery?
A: Since clefting causes many physical changes, a cleft lip is easy to diagnose. The diagnostic procedures include prenatal ultrasound. In this test, Cleft Lip or Palate is identified if the child is having inborn defects. If it is not diagnosed by ultrasound then the physical exam of the mouth, nose and palate will confirm the defect.

Q: How can I feed my child until surgery?
A: Children with a cleft palate need to wear an artificial palate to help them eat properly and ensure that they are receiving enough food until surgical treatment is provided. Specially designed baby-bottles with nipples are available for better feeding.

Q: How frequent this cleft lip and cleft palate defect occurs?
A: Cleft lip with or without palate is the fourth most common birth defects in the U.S. and approximately 1 in 700 babies are affected. It is reported to occur more often in children from Asia, Latino or Native American descent. Cleft lip is more common in boys whereas cleft palate is more often found in girls. 

Q: What is the age of the child to perform the cleft surgery for lip and palate?
A: Cleft lip repair is done when the child is 3 to 6 months old. Mostly, cleft palate repair is done when the child is older, between 9 months and 1 year old. This allows the palate to change as the child grows. Doing the repair when the child is at this age will help prevent further speech problems as the child develops.

Q: How many surgeries are needed after main surgery?
A: Sometimes a child will need more than one surgery to close the palate. During these procedures, the surgeon may also need to repair the tip of your child's nose. This surgery is called rhinoplasty.

Q: What is the prognosis of the cleft lip and palate defect?
A: Most babies heal without problems. The healing depends on the seriousness of the defect. Hearing and speech tests should be performed before and after surgery. The teeth may also need correction as they come.

Q: Which cities in India have hospitals to cater the procedures of Clift Lip Surgery?
A: Mumbai, Hyderabad, Kerala, Delhi, Pune, Goa, Bangalore, Nagpur, Jaipur, Chennai, Gurgaon, Chandigarh.