Incidence:

These deformities occur approximately once in every 500 births. There is a low risk of inheritance. The more severe types of cleft seem to also have a higher risk.

Development:

In the early weeks of development (Before 12 weeks of pregnancy), the right and left sides of the lip and the roof of the mouth normally grow together. In about one of every 500  babies, those sections don't quite meet. A child born with a separation in the upper lip is said to have a cleft lip. A similar birth defect in the roof of the mouth, or palate, is called a cleft palate. Since the lip and the palate develop separately, it is possible for a child to have a cleft lip, a cleft palate, or variations of both.

When a cleft palate is present the baby is unable to suck, but it is important to remember that it can swallow normally. Milk is dribbled onto the back of the baby’s tongue through a large hole in a large teat of a squeeze plastic bottle or by an eyedropper or with the help of a spoon, keeping the child in little upright position to prevent regurgitation through nose. Burping after each feed is extremely important as these child swallow lot of air along with milk. Vaccination should be carried out as per schedule.

Team Approach:

Children born with a cleft lip or palate may need the skills of several medical professionals to correct the problems associated with the cleft. Typically, a Cleft Team consist of a plastic surgeon (As Head of the team), a pediatrician, a dentist, a speech and language specialist, a social worker, a hearing specialist, an ear-nose-throat specialist, a psychologist, a nurse, and a genetic counselor.

Timing of Surgery:

Cleft lip surgery is generally done when the child is about 10 weeks old. Cleft palate repair require more extensive surgery and is usually done when the child is nine to 18 months old, so the baby is bigger and better able to tolerate surgery.

Postoperative:

By and large babies tolerate surgeries very well. They are discharged generally from the hospital on 3^rd or 4^th postoperative day.

Hypospadias and other Genito-urinary abnormalities

Hypospadias occurs in approximately 1 in 300 male births. Primary surgery is performed by a plastic surgeon between the age of 2 to 3 years. Efforts are made to complete in one stage but sometime more than one surgery is required. All operations are completed before child starts going to school. Other congenital abnormalities of the penis and absence of the vagina are also treated by plastic surgeons.

Congenital deformities of the hand-that is, deformities a child is born with-can interfere with proper hand growth and cause significant problems in the use of the hand. Fortunately, with modern surgical techniques most defects can be corrected at a very early age-in some cases during infancy, in others at two or three years-allowing normal development and functioning of the hand. Plastic surgeons can usually restore comfort, mobility, and normal appearance to patients with hand problems.

Children born with syndactyly (webbed fingers) can benefit from finger separation. If a child has a polydactyly (extra fingers) or duplicate thumb, correction is often more than simply removing the extra digits. The surgeon may also need to balance the tendons of the hand and stabilize the remaining finger joints for better hand function.

Cranio facial defects

This is a specialist area requiring the expertise of plastic surgeons, neurosurgeons, oral and maxillofacial surgeons, ophthalmologists, paediatricians and others.