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A study into weight gain in infants with cleft lip/palate
1The General Infirmary, Leeds.
Insights
Infants with cleft lip and palate often struggle with weight gain due to feeding difficulties. Specialized nurse support in England and Wales has improved infant weight outcomes, identifying at-risk infants for timely intervention.
Area of Science:
- Pediatric surgery
- Clinical nutrition
- Public health services
Background:
- Faltering weight in infants with cleft lip and palate is often linked to feeding challenges.
- Reorganization of cleft services in England and Wales introduced clinical nurse specialists for early feeding management.
Purpose of the Study:
- To assess failure to thrive (FTT) levels in infants with cleft lip and/or palate.
- To compare FTT rates with previous UK data and the general population.
- To evaluate the impact of regional cleft services and specialist feeding support on infant weight gain.
Main Methods:
- Retrospective review of medical records for 187 infants with cleft lip and/or palate.
- Analysis of birth weight and primary surgery records to determine FTT.
- Comparison of FTT rates and weight gain trends before and after the introduction of regional services.
Main Results:
- FTT varied by cleft type and presence of other anomalies.
- Infants with isolated cleft lip had average birth weights; those with cleft lip and palate were smaller; isolated cleft palate infants were significantly lighter (P=0.002).
- The cohort demonstrated improved weight gain compared to pre-regional service data.
Conclusions:
- Clinical nurse specialist-led feeding support improves weight gain outcomes in infants with cleft lip and palate.
- Identification of high-risk infant groups allows for prioritized, targeted interventions.
- Specialized care models enhance growth trajectories for infants with complex congenital conditions.
Abstract:
Faltering weight (or failure to thrive) in infants with cleft lip and palate has largely been attributed to early feeding difficulties. In recent years, the reorganisation of cleft lip and palate services in England and Wales into regional teams has seen the introduction of clinical nurse specialists, who provide early feeding management. The medical records of 187 infants with cleft lip and/or palate were reviewed. Records of their weight at birth and of primary lip and palate surgery were used to calculate levels of failure to thrive and these were compared to levels previously reported in the UK and to the general population. It was found that failure to thrive was linked to cleft type and the presence of other anomalies. Infants with isolated cleft lip had similar birth weights to the general population, while those with cleft lip and palate were smaller than average, and those with isolated cleft palate were significantly lighter (P = 0.002). Compared with records made before the introduction of regional services, this cohort showed an improvement in weight gain. It was concluded that feeding support provided by clinical nurse specialists can improve outcomes and, with their new knowledge of groups at particular risk of poor growth, can enable appropriate interventions to be prioritised.
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