Nutrition support for children with clefts

Smile Train’s vision for Cleft Nutrition Programs is a world where every baby born with a cleft has the opportunity to thrive and grow

Nutrition has taken a center stage with the Prime Minister announcing the month of September as Rashtriya Poshan Maah (National Nutrition Month) which strives to promote nutrition awareness and support for children, pregnant women and lactating mothers to eliminate malnutrition from the country. To ensure community mobilization and bolster grassroots level participation, the government also encourages participation of non-profit organizations to achieve optimum outcomes. Smile Train, the world’s largest cleft-focused NGO, supports 100% free cleft surgeries and comprehensive cleft care services and joins the league to build measures to eliminate malnutrition, more so applying a lens to the specialized nutritional needs for children with clefts.

Although with policy level interventions, India has made remarkable progress in the past few decades, malnutrition continues to be a major developmental challenge in India. As per NFHS 5 findings, in India, 32.1%, 35.5% and 19.3% of children under the age of five are underweight, stunted and wasted respectively. In accordance with data collated from Smile Train Partner Hospitals, 20-30% children born with cleft lip and palate are unable to receive timely surgery due to malnutrition.

Importance of Nutrition in children with clefts

One in 700 children is born with a cleft lip and/or palate in India; annually, this translates to more than 35,000+ live cleft births in the country. Children with cleft lip and palate are uniquely vulnerable to malnutrition and subsequent growth problems, even when food supply is abundant. This is because clefts affect their ability to suckle and often make it very difficult to breast or bottle-feed. Malnutrition among children with clefts increases the risks for infection, illness or morbidity, and delays the life-transforming cleft surgery process. In extreme cases, malnutrition in a child with cleft can also lead to loss of a life. However, with proper knowledge and guidance, this can be prevented, treatment can be provided on time, and all other associated developmental delays can be addressed.

Mobile Nutrition Van.

Smile Train’s Nutrition Program

Smile Train’s vision for Cleft Nutrition Programs is a world where every baby born with a cleft has the opportunity to thrive and grow, without being held back by any feeding challenges related to their cleft.

The Smile Train Nutrition Program serves as a nutrition resource for treatment partner hospitals, cleft teams, and those affected by clefts around the world. The Nutrition Program envisions to act as a safety net to ensure that children with clefts receive timely nutrition care and treatment and are able to combat the reversible condition to grow on par with their peers. The comprehensive programs encompass three levels of support for feeding and nutrition:

  • Feeding counseling for mothers and families
  • Nutrition assessment for patients with clefts
  • Nutrition care before and after surgery
Celebrating Poshan Maah with partner hospitals. 

While all cleft teams at treatment partner hospitals across India are equipped to provide feeding counseling for mothers and families, Smile Train India aims to expand their Nutrition Assessment and Care Program across the country so that children can receive their cleft surgery at the optimal age. Smile Train India piloted their nutrition assessment and support program in 2019 and this service has now been extended to 34 treatment partners across 12 states. The project aims to increase nutrition support programs by 35% in the next 12 months. Under this program, Smile Train partner hospitals provide nutrition assessment, counseling and supplementary nutrition support to children with clefts from initial screening, till the period of post-operative care. Smile Train’s sustainable model of empowering and training local healthcare workers fosters long-term relationships between families and cleft teams. This allows Smile Train’s partner hospitals to ensure that the parents of children with clefts receive the right guidance for nutritional well-being from birth to completion of cleft surgery.

Nutrition awareness session in progress.

Ushering in behavior & practice level changes to reduce malnutrition

Mamta Carroll

 “Smile Train is uniquely positioned to support the needs of children with clefts and our sustainable model is designed to foster long-term relationships between families and cleft care professionals. The concerns related to malnutrition among children with clefts are consciously included in our program and addressed to yield greater results in improving the nutrition indicators among children with clefts both before and after surgery. Although nutrition remains a core focus area for Smile Train, bringing a sustainable change would require increased community understanding of clefts, government and multi-sectoral awareness and collaborative actions. Poshan Maah, celebrated across the nation, provides one such opportunity and we are determined to leverage that optimally,” says Mamta Carroll, Senior Vice President and Regional Director Asia, Smile Train.

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