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Day: October 25, 2026

25Oct

If your baby has been born with a cleft lip or palate, or a scan has shown one, you probably feel
worried and have many questions. That is completely natural. Cleft conditions are among the most common birth differences, and with the right care, children can eat, speak, smile, and grow up healthy and confident. This guide explains what to expect, stage by stage.

What Are Cleft Lip and Cleft Palate?

During early pregnancy, the tissues of the baby’s face and mouth grow towards each other and join.
A cleft happens when they do not fully close.
• Cleft lip: A gap or split in the upper lip. It can be on one side or both sides, and it can be small or
extend up into the nose.
• Cleft palate: A gap in the roof of the mouth. It may involve the hard palate at the front, the soft
palate at the back, or both.
• Cleft lip and palate together: Some babies have both.
It is not your fault. A cleft is not caused by anything a parent did or did not do. Parents often blame
themselves, but this is a developmental difference, and no one should feel guilty about it.

• Cosmetic (aesthetic) surgery, which reshapes normal features to improve appearance and confidence. So cosmetic surgery is one part of plastic surgery, not a separate field.

How Is It Detected?

Some clefts are seen on an ultrasound scan during pregnancy, especially cleft lip. Others, particularly a cleft palate inside the mouth, are found only after the baby is born. If a scan shows a cleft, you can meet a plastic surgeon before delivery to understand the plan and ask questions.

The First Weeks: Feeding Support

Feeding is often the first challenge, particularly with a cleft palate, because the baby may find it hard
to create the suction needed to feed.
• Special bottles and teats designed for babies with clefts can help.
• Holding the baby in a more upright position can reduce choking and milk coming through the nose.
• Feed slowly and burp often, because babies may swallow extra air.
• Ask your paediatrician or surgeon about feeding techniques and weight monitoring.
Most babies with clefts grow well once the right feeding method is found. Do not hesitate to ask for
help early.

The Treatment Timeline

Every child is different, and the exact timing depends on the type of cleft, the baby’s weight and
health, and the surgeon’s protocol. The stages below are a general guide, and your surgeon will give
you a plan for your child.

Stage 1: Newborn period
Assessment, feeding support, and a care plan. Some centres use a moulding device to gently shape
the lip and gum before surgery, but this is not used in every case.
Stage 2: Cleft lip repair (typically in the first few months)
Surgery closes the lip and often reshapes the nostril at the same time. The aim is a lip that works well
and looks natural, with a scar that fades over time.
Stage 3: Cleft palate repair (typically in the first year or so)
Surgery closes the gap in the roof of the mouth and rebuilds the muscles of the soft palate. This is
important for feeding and for developing clear speech.
Stage 4: Speech and hearing care (through early childhood)
Children with cleft palate have a higher chance of ear infections and fluid behind the eardrum, so ear
checks and hearing tests are important. A speech therapist monitors development. Some children
need speech therapy, and a few need a further procedure to improve speech.
Stage 5: Dental and orthodontic care (childhood onwards)
Clefts can affect how teeth grow. Regular dental care and orthodontic treatment are part of the
long-term plan.
Stage 6: Gum bone grafting (typically in later childhood)
If the cleft involves the gum, a bone graft may be done to support the teeth, usually before the
permanent teeth come through at the cleft site.
Stage 7: Later refinements (teenage years, if needed)
Some young people choose or need procedures to refine the nose, lip scar or jaw once growth is
complete. Not every child needs these.

The Team Behind Your Child’s Care

Cleft care works best when a team looks after the child together, often over many years:
• Plastic surgeon for lip and palate repair and later reconstruction
• Paediatrician for general health, feeding and growth
• ENT specialist for ear and hearing care
• Speech and language therapist for speech development
• Dentist and orthodontist for teeth and jaw growth
• Anaesthetist for safe care during surgery
• Counsellor or social support for the family

Cleft Lip

Looking After Yourself as a Parent

Before surgery: The team checks your baby’s weight, general health and blood tests to be sure the
baby is fit for anaesthesia. You will be told when to stop feeding before the operation.
After surgery: Babies usually stay in hospital for a short time. Pain is managed with medicines, and
you will be taught how to feed, clean and protect the repair. Babies may need soft arm splints or a
particular feeding method for a while so they do not touch the stitches.
At home: Follow wound care instructions carefully, keep follow-up appointments, and call the team if
you notice bleeding, fever, or poor feeding. The scar is red at first and fades gradually over many
months.

Cleft Lip and Palate Care in Thrissur with Dr. Jyoshid R. Balan

Dr. Jyoshid R. Balan is a plastic and reconstructive surgeon at Sushrutha Institute of Plastic Surgery,
Elite Mission Hospital, Thrissur. His practice includes cleft lip and palate surgery as part of his wider
work in congenital and reconstructive care. Families are guided through each stage, from the first
consultation to long-term follow-up.
If your baby has a cleft, or you want to meet a surgeon before delivery, book a consultation at
drjosh.in/contact or call +91 8113005557.

Frequently Asked Questions (FAQ)

1. What causes a cleft lip or palate?

A cleft forms when the tissues of the face and mouth do not fully join in early pregnancy. Causes can involve genes and the environment, and it is rarely due to anything a parent did. It is not your fault.

2. Can a cleft be seen before birth?

Cleft lip can often be seen on a detailed ultrasound scan, but a cleft palate is harder to detect and is
sometimes found only after birth.

3. At what age is cleft lip surgery done?

It is usually done in the first few months of life, once the baby is healthy and gaining weight. Your
surgeon will advise the best timing for your baby.

4. At what age is cleft palate surgery done?

It is usually done in the first year or so. The timing balances healing, speech development and your
baby’s health, and your surgeon will confirm it for your child.

5. Will my baby be able to feed normally?

Yes, with the right support. Babies with clefts may need special bottles or positions at first, and
feeding usually becomes easier, especially after palate repair.

6. Will my child be able to speak clearly?

Most children develop good speech after palate repair, often with help from a speech therapist. A few need further treatment, and the team will monitor progress.

7. Will there be a scar?

Yes, but it is usually thin and fades with time. The surgeon works to make the lip look as natural as
possible.

8. Will my child need more than one surgery?

Often yes. Lip and palate repair are the main operations, and some children later need a gum bone
graft or refinement of the nose, lip or jaw. Each child’s plan is different.

9. Why are ear checks important?

Children with cleft palate are more prone to fluid and infections in the middle ear, which can affect
hearing and therefore speech. Regular ear and hearing checks help catch problems early.

10. Can I have another baby with a cleft?

The chance is slightly higher in some families. If you are planning another pregnancy, a doctor or
genetic counsellor can explain your situation.

 

11. How can i book appointment Dr. Jyoshid R Balan?

You can book a consultation with Dr Jyoshid R. Balan by contacting his clinic directly.

Sushrutha Institute of Plastic Surgery
Elite Mission Hospital, Koorkenchery, Thrissur, Kerala – 680007
Phone / WhatsApp: +91 81130 05557
Email: drjosh4u@gmail.com

You can also use the Book Now option on his official website:

Book an appointment with Dr. Jyoshid R Balan

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