Key Points:
Nana Patekar lost his two-year-old son who was born with cleft palate.
Cleft palate occurs when the roof of the mouth does not fuse during early pregnancy.
Children with clefts in India are 1.5 times more vulnerable to severe malnutrition.
Early surgery, nutrition support, and speech therapy improve outcomes.
Integrated cleft care is essential to reduce preventable mortality in India.
Veteran actor Nana Patekar recently shared the deeply personal story of losing his eldest son, Durvasa, at just two and a half years old. Durvasa was born with a cleft palate and faced significant health challenges from infancy, including difficulty seeing through one eye.
In an emotional recollection, Patekar admitted that his first reaction was not solely concern about treatment. He worried about how society would perceive his child’s facial difference. He later described feeling ashamed of those thoughts, calling himself a terrible person for allowing social judgment to cloud his response as a father.
Cleft palate is a birth defect in which the roof of the mouth does not completely fuse during early fetal development. The palate normally forms between the sixth and ninth week of pregnancy. When tissues fail to join properly, an opening remains between the oral and nasal cavities.
Cleft palate can occur with or without cleft lip. Because the lip and palate develop separately, some children may have only one defect while others have both.
The palate plays a crucial role in feeding, speech production, and separating airflow between the mouth and nose. When it does not form properly, multiple functional challenges arise.
According to clinical data:
About 1 in 1,700 babies is born with cleft palate alone.
About 1 in 1,600 babies is born with both cleft lip and cleft palate.
About 1 in 2,800 babies is born with cleft lip without cleft palate.
These numbers vary across populations, but the condition remains among the most common congenital birth defects globally.
In India, children with cleft lip and palate face an additional and serious threat. A recent study highlighted by Smile Train India revealed that children under five with orofacial clefts are approximately 1.5 times more likely to be severely malnourished compared to children without clefts.
The study further estimated that 33.6 percent of malnutrition-related deaths among children with clefts could potentially be prevented with timely nutritional support and surgical intervention.
Feeding difficulties largely drive this vulnerability. Infants with cleft palate often struggle to create adequate suction during breastfeeding or bottle feeding. Milk may pass into the nasal cavity, leading to poor intake, fatigue during feeding, and inadequate weight gain. Without early intervention, this can progress to severe malnutrition.
This data positions cleft palate not only as a surgical issue but also as a critical public health and nutrition concern in India.
Dr. Munish Kumar Raizada, MD, FAAP (Neonatologist), shared brief knowledge about the causes of Cleft lip and Cleft Palate.
Cleft palate typically results from a combination of genetic and environmental factors. In many cases, clinicians cannot identify a single cause.
Known risk factors include:
Family history of cleft lip or palate
Maternal smoking or alcohol consumption during pregnancy
Poor maternal nutrition, particularly folic acid deficiency
Certain medications taken during pregnancy such as antiseizure drugs or isotretinoin
Maternal obesity and exposure to harmful substances
Most cases arise from multifactorial causes involving both genetic susceptibility and environmental triggers during early pregnancy.
Infants often struggle to generate suction, making breastfeeding difficult. Specialized bottles and feeding techniques are frequently required to ensure adequate nutrition before surgery.
The palate is essential for proper sound formation. Children with unrepaired cleft palate may develop hyper nasal speech or articulation difficulties due to air escaping through the nose during speech.
Children with cleft palate commonly experience fluid buildup in the middle ear. This increases the risk of recurrent ear infections and possible hearing impairment if not monitored.
Cleft conditions can affect tooth eruption, alignment, and jaw growth. Many children require orthodontic care as they grow.
Management of cleft palate requires long-term coordinated care involving multiple specialists.
Cleft lip repair is typically performed between three and six months of age.
Cleft palate repair usually occurs around nine to twelve months of age to support speech development.
Some children may require additional corrective surgeries later in childhood or adolescence.
Before surgery, infants may need specialized feeding devices and monitoring to prevent malnutrition.
Speech-language therapy plays a crucial role in improving articulation and communication skills. Some children may require secondary procedures if speech problems persist.
Regular hearing evaluations help prevent long-term auditory complications.
A typical cleft care team may include pediatricians, plastic surgeons, ENT specialists, audiologists, orthodontists, speech therapists, and psychologists.
Nana Patekar’s reflection draws attention to an often overlooked aspect of cleft conditions. Families face issues not only for medical treatment but also social stigma, emotional distress, and financial strain.
In India, delayed treatment often stems from lack of awareness, limited access to surgical centers, and economic barriers.
References:
1. Smile Train India. “New Study Reveals Children with Orofacial Clefts in India Are 15 Times More Vulnerable.” Accessed February 23, 2026. https://www.smiletrainindia.org/news/new-study-reveals-children-orofacial-clefts-india-are-15-times-more-vulnerable.
2. Cleveland Clinic. “Cleft Lip & Cleft Palate: Causes & Treatment.” Cleveland Clinic Health Library. Last updated January 25, 2024. Accessed February 23, 2026. https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate.