Faltering weight in infants with cleft lip and palate

Area of Science:

• Pediatric Surgery
• Neonatal Nutrition
• Cleft Lip and Palate Care

Background:

• Feeding difficulties and faltering growth are common in neonates with cleft lip and palate, potentially delaying surgery and impacting recovery.
• UK cleft services were restructured in 1998, emphasizing multidisciplinary teams and specialist nurses for early feeding assessment and support.

Purpose of the Study:

• To evaluate the impact of integrated, multidisciplinary cleft care on patient nutrition since service centralization.
• To assess if early feeding interventions effectively address and prevent faltering weight in neonates with clefts.

Main Methods:

• Retrospective review of 97 patients undergoing cleft lip and/or palate repair between January 2018 and December 2019.
• Data collected included birth weight, gestational age, cleft type, syndromic status, and weight/age at primary surgery.
• Growth centiles were calculated at birth, primary surgery, and later surgeries to track nutritional progression.

Main Results:

• Analysis identified patients with suboptimal weight progression.
• Early feeding assessment and intervention were demonstrated to positively impact weight gain.
• Findings were statistically analyzed and compared with historical data.

Conclusions:

• Integrated, multidisciplinary cleft care, including early feeding support, is effective in improving nutritional outcomes for neonates with clefts.
• Proactive nutritional management is crucial for optimizing growth and surgical readiness in this patient population.