Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. As per the Centers of Disease Control and Prevention (CDC), the lip forms between the fourth and seventh weeks of pregnancy. During development, body tissue and cells from each side of the head grow towards the center of the face. They join together to form facial features like the lips and mouth. So, How Does Cleft Lip Happen?A cleft lip happens if the tissue making up the upper lip does not join completely before birth, leaving an opening. The opening can be small, or it can go through the lip into the nose. A cleft lip can be on one or both sides of the lip. It can also be in the middle of the lip. Children with a cleft lift can also have a cleft palate. A cleft palate happens if the tissue that makes up the roof of the mouth, which is the palate does not join together. It could be the front and back part of the palate which remains open, or partially either of them remain open. Together, these birth defects are called orofacial clefts. To know more about this condition and whether it is necessary to get it fixed surgically, we spoke to Dr Niranjan Kumar, Consultant, Plastic Surgeon, and Vice-Chancellor of SDM University. Is Surgery Necessary?Dr Kumar pointed out that if cleft lip or cleft palate is not fixed through surgery, then it could lead to problems in feeding, leading to nutritional deficiencies and growth retardation. There will also be a delayed in speech, delayed eruption and malocclusion of teeth. It could also lead to recurrent chest infections, frequent middle ear infections and then lead to defective hearing. " If neglected, this defect adversely affects the social life of child due to the inferiority complex associated with the appearance and defective speech. This leads to the retardation of the child's overall personality development," said Dr Kumar.SDM Craniofacial surgery and Research Center has also started its own program in collaboration with Dharwad and The Smile Train, New York, USA of free treatment to fix these conditions in children. Dr Kumar pointed out that in India, this happens to 1 on average of 550 live births. This means that there are more than 10 lakhs cleft children in the country. What Causes It?"There are no definite causes for cleft deformity. But, genetic factors and changes in the fetal environment have been implicated as possible causes. Illness during the pregnancy, nutritional deficiencies, ingestion of harmful medications and exposure to contagious diseases during pregnancy may also be the contributing factors," the doctor explained. Available TreatmentsDr Kumar points out that affected children if treated at early age, have a better chance of leading a normal life like any other normal children. "Surgical treatment is the only solution. The surgery for cleft lip and palate can be performed from 6 months of age. However, it depends on the growth and development of the child at that particular age. For the effective treatment of the defect, it may require 2 to 3 surgeries and this depends on the severity of the defect," he explained. Steps to be followed by the parents of a child with cleft lip and palate deformity: When a child is born with a defect, the parents should not get disheartened. They should consult the concerned doctors and follow their instructions. As far as possible breast feeding should be encouraged.