Anthropometric status among infants with cleft lip and palate: a cross-sectional, single-center study in Indonesia
Andi Setiawan Budihardja1, Patriana Yossy2
1Dept/Oral maxillofacial Surgery, Faculty of Dentistry, Universitas Pelita Harapan Tangerang-Indonesia, and Comprehensive Cleft Center Siloam Lippo Village, Tangerang, Indonesia. abudihardja79@gmail.com.
Insights
Infants with cleft lip and/or palate (CL/P) show higher rates of stunting, a sign of chronic growth restriction. Acute undernutrition (wasting) did not differ, suggesting gradual growth deficits in CL/P infants.
Area of Science:
- Pediatric Nutrition
- Craniofacial Anomalies
- Growth Monitoring
Background:
- Infants with cleft lip and/or palate (CL/P) face feeding challenges, increasing risks of growth faltering.
- Limited data exist on anthropometric outcomes for CL/P infants in Indonesia compared to non-cleft peers.
Purpose of the Study:
- To compare anthropometric indicators of undernutrition between infants with CL/P and those without craniofacial anomalies.
- To evaluate growth differences in infants presenting at a single Indonesian hospital.
Main Methods:
- Cross-sectional study of 174 infants (<1 year old): 87 with CL/P, 87 controls.
- Anthropometric data (length-for-age z-scores, weight-for-length z-scores) from electronic medical records.
- Stunting defined as LAZ <-2 SD; wasting as WLZ <-2 SD; analyzed using chi-square tests.
Main Results:
- Significantly higher prevalence of stunting in CL/P infants (52.9%) versus controls (5.7%; P < 0.001).
- No significant difference in wasting between CL/P infants (2.3%) and controls (2.3%; P = 0.069).
- Anthropometric status was not associated with specific cleft types (P = 0.989).
Conclusions:
- CL/P infants exhibit a substantially higher prevalence of stunting, indicating chronic growth restriction.
- Wasting, an indicator of acute undernutrition, was similar between groups, suggesting gradual growth deficits.
- Interventions focusing on feeding, nutrition, caregiver support, and multidisciplinary care are crucial for improving outcomes in CL/P infants.
Objective:
Infants with cleft lip and/or palate (CL/P) may experience feeding difficulties that place them at increased risk of growth faltering. However, data comparing anthropometric outcomes between infants with CL/P and non-cleft infants in Indonesia remain limited. This study aimed to compare anthropometric indicators of undernutrition between infants with CL/P and infants without craniofacial anomalies evaluated at the same hospital.
Methods:
This cross-sectional study included 174 infants aged <1 year (87 with CL/P and 87 without craniofacial anomalies). Anthropometric data were obtained from electronic medical records at a single cleft center and the paediatric department of the same hospital. Length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ) were calculated according to World Health Organization (WHO) Child Growth Standards. Stunting was defined as LAZ <-2 standard deviations (SD), and wasting as WLZ <-2 SD. Associations between CL/P and anthropometric status were analysed using χ² tests.
Results:
The mean age was 6.0 ± 3.9 months in the CL/P group and 5.6 ± 2.6 months in the comparison group. Infants with CL/P had a significantly higher prevalence of stunting than infants without craniofacial anomalies (52.9% vs. 5.7%; P < 0.001). No significant difference was observed in wasting between the groups (2.3% vs. 2.3%; P = 0.069). Anthropometric status was not associated with cleft type (P = 0.989).
Discussion:
Infants with CL/P demonstrated a substantially higher prevalence of stunting, an indicator of chronic growth restriction, whereas wasting, an indicator of acute undernutrition, did not differ between groups. These findings suggest that growth deficits in infants with CL/P may accumulate gradually over time rather than manifest primarily as acute nutritional deterioration.
Conclusion:
Infants with CL/P may be vulnerable to chronic growth restriction during early life. Strengthening early feeding assessment, nutritional surveillance, caregiver education, breastfeeding support, and multidisciplinary cleft care may help reduce growth faltering and improve outcomes.
