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Evaluation of growth in patients with isolated cleft lip and/or cleft palate
Yuri A Zarate1, Lisa J Martin, Robert J Hopkin
1Cincinnati Children's Hospital Medical Center, Division of Human Genetics, 3333 Burnet Ave, MLC 4006, Cincinnati, OH 45229, USA.
Insights
Children with cleft lip and/or palate show initial decreases in weight and length during infancy, followed by significant recovery. Feeding interventions positively impact growth in these patients.
Area of Science:
- Pediatric Growth
- Craniofacial Anomalies
- Nutritional Science
Background:
- Cleft lip (CL) and cleft palate (CP) are common congenital anomalies affecting growth.
- Early growth patterns in these patients require careful monitoring.
Purpose of the Study:
- To evaluate the growth trajectory of infants and young children with isolated CL/CP or CP.
- To identify factors influencing growth, such as feeding interventions.
Main Methods:
- Retrospective analysis of 307 patients (birth to 5 years) with CL/CP or CP.
- Anthropometric data plotted on CDC growth charts; longitudinal analysis performed.
- Impact of feeding interventions and early education assessed.
Main Results:
- No significant failure to thrive observed in the cohort.
- Initial decreases in weight and length percentiles during the first year, followed by significant recovery.
- Patients receiving feeding interventions showed improved weight-for-length gain.
Conclusions:
- Weight and length decreases in the first year are not clinically significant and are followed by recovery.
- Successful feeding interventions and education appear to support growth recovery.
- Head circumference and weight-for-length demonstrate consistent gain over time.
Objective:
The purpose of the study was to evaluate the growth of patients with isolated cleft lip (CL), with or without cleft palate (CP), or CP during the first few years of life.
Methods:
A retrospective analysis of data from birth to 5 years for 307 patients with isolated CL/CP or CP alone who were seen in a large craniofacial center between 1980 and 2007 was performed. We analyzed growth patterns and feeding interventions. Anthropometric values were plotted onto 2000 Centers for Disease Control and Prevention charts. Longitudinal analyses were performed to estimate age-related changes and to test whether feeding interventions or early education influenced age-related changes.
Results:
Including progressive weight, length, and head circumference values, a total of 1944 data points were available. The most frequent diagnosis was unilateral CL with CP (165 [53.7%] of 307 cases). No patients experienced significant failure to thrive during the study period, although predicted weight and length percentiles for age had initial decreases during the first year of life, with nadirs at 5.2 and 15 months, respectively. These decreases were followed by recovery that started at approximately 12 months for weight and at 20 months for length (P < .0001). Patients who had feeding interventions had a significantly (P = .047) increased gain rate over time for weight for length, compared with those who did not.
Conclusions:
In this population, there were weight and length decreases during the first year of life, which were not clinically significant and were followed by statistically significant recovery. Recovery seemed to be related to successful education and feeding interventions. Head circumference and weight for length started at lower percentiles but showed consistent gain over time.
