Initial Nutritional Assessment of Infants with Cleft Lip and/or Palate: Interventions and Return to Birth Weight

2017 ◽  
Vol 54 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Alison Kaye ◽  
Kristi Thaete ◽  
Audrey Snell ◽  
Connie Chesser ◽  
Claudia Goldak ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nutritional Assessment ◽  
Initial Assessment ◽  
Average Birth Weight ◽  
Nutritional Interventions

Objective To assess and quantify cleft team practices with regard to nutritional support in the neonatal period Design Retrospective review. Setting Tertiary pediatric hospital. Patients One hundred consecutive newborn patients with a diagnosis of cleft lip and/or cleft palate between 2009 and 2012. Main Outcome Measures Birth weight, cleft type, initial cleft team weight measurements, initial feeding practices, recommended nutritional interventions, and follow-up nutritional assessments. Results All patients in the study were evaluated by a registered dietitian and an occupational feeding therapist. Average birth weight and average age at the first cleft team visit were similar for each cleft type: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP). The calculated age (in days) for return to birth weight was significantly different between cleft types: CL = 13.58 days, CLP = 15.88 days, and CP = 21.93 days. Exclusive use of breast milk was 50% for patients with CL, 30.3% for patients with CLP, and 21.4% for patients with CP. Detailed nutritional interventions were made for 31 patients at the first visit: two with CL, 14 with CLP, and 15 with CP. Conclusions Distinct differences were seen in neonatal weight gain between cleft types. There was significantly greater total weight gain for patients with CL at their first visit and significantly slower return to birth weight for patients with isolated CP. Patients with CL required far fewer interventions at the initial assessment and were more likely to be provided breast milk exclusively or in combination with formula. Infants with CP were far less likely to receive any breast milk. Patients with CLP and CP required frequent nutritional interventions.

Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
Author(s):  
Lisa H. V. Smedegaard ◽  
Dorthe R. N. Marxen ◽  
Jette H. V. Moes ◽  
Eva N. Glassou ◽  
Cand Scientsan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Health Visitors ◽  
Facial Clefts ◽  
Growth References ◽  
First Year Of Life ◽  
Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

scholarly journals Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Renato da Silva Freitas ◽  
Andrey Bernardo Lopes-Grego ◽  
Helena Luiza Douat Dietrich ◽  
Natacha Regina de Moraes Cerchiari ◽  
Tabatha Nakakogue ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
World Health ◽  
First Year ◽  
Average Weight ◽  
Syndromic Diagnosis ◽  
Health Organization ◽  
First Year Of Life

Goals/Background. To evaluate children’s growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

Repair of Recurrent Cleft Palate with Free Vastus Lateralis Muscle Flap

2012 ◽  
Vol 49 (2) ◽  
pp. 245-248 ◽  
Author(s):  
Jose G. Christiano ◽  
Amir H. Dorafshar ◽  
Eduardo D. Rodriguez ◽  
Richard J. Redett
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Vastus Lateralis ◽  
Muscle Flap ◽  
Free Flaps ◽  
Vastus Lateralis Muscle ◽  
Oronasal Fistula ◽  
Lateralis Muscle ◽  
Palate Repair

A 6-year-old girl presented with a large recalcitrant oronasal fistula after bilateral cleft lip and palate repair and numerous secondary attempts at fistula closure. Incomplete palmar arches precluded a free radial forearm flap. A free vastus lateralis muscle flap was successfully transferred. No fistula recurrence was observed at 18 months. There was no perceived thigh weakness. The surgical scar healed inconspicuously. Free flaps should no longer be considered the last resort for treatment of recalcitrant fistulas after cleft palate repair. A free vastus lateralis muscle flap is an excellent alternative, and possibly a superior option, to other previously described free flaps.

Results of Multidisciplinary Management of Bilateral Cleft Lip and Palate at the Iowa Cleft Palate Center

1992 ◽  
Vol 89 (3) ◽  
pp. 419-432 ◽  
Author(s):  
Janusz Bardach ◽  
Hughlett L. Morris ◽  
William H. Olin ◽  
Steven D. Gray ◽  
David L. Jones ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multidisciplinary Management ◽  
Bilateral Cleft Lip

Morphological Presentation of Orofacial Clefts: An Epidemiological Study of 5004 Patients in a Tertiary Care Hospital of Central India

2021 ◽  
pp. 105566562110577
Author(s):  
Jaideep Singh Chauhan ◽  
Sarwpriya Sharma
Keyword(s):  
Cleft Palate ◽  
Epidemiological Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
Central India ◽  
Care Hospital ◽  
Orofacial Clefts ◽  
Chi Square ◽  
The Right

Objective: To analyse the morphological presentation of orofacial clefts, gender, syndromes and systemic anomalies associated with them. Design: This was an epidemiological study performed in the patients who were registered for cleft lip and palate surgeries in our centre. The data was evaluated both retrospectively as well as prospectively. Patients/ Participants: The patients registered from November 2006 to April 2021 were studied. Out of 5276 patients, data of 5004 cases were analysed, rest 272 patients were excluded due to lack of information. Statistical analysis and Chi square test were applied. Results: Cleft deformities were more common in males than females. Cleft lip with palate was the commonest phenotype (52.2%). It was followed by isolated cleft lip (22.9%), isolated cleft palate (22.1%), rare clefts (1.62%) and syndromic clefts (1.18%). Unilateral variants were more frequent than bilateral. In unilateral, left side was more common than the right side. Among bilateral, most of the cases had premaxillary protrusion. In the present study, 3.46% of all the patients had associated anomalies affecting their other organs. Less common cleft phenotypes like microform cleft lip and submucous cleft palate ± bifid uvula showed frequency of 0.62% and 0.64% respectively. Conclusion: Thorough examination of cleft deformity should be done as it may appear as an isolated deformity or part of a syndrome and have associated systemic anomalies. This may help us to deliver comprehensive care to the patients and can prevent potential operative complications.

Global Cleft Lip and Palate Outreach: A Google Trends Analysis

2021 ◽  
pp. 105566562110698
Author(s):  
Joshua P Weissman ◽  
Narainsai K Reddy ◽  
Nikhil D Shah ◽  
Arun K Gosain
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Philippines ◽  
Google Trends ◽  
World Health ◽  
Patient Awareness ◽  
Number Of Patients ◽  
Who Indicators ◽  
Cleft Surgery

Understanding patient awareness of cleft lip and/or palate (CL/P) and evaluating demand for necessary procedures may serve to better target future efforts in global outreach. We utilized internet search query data from Google Trends for the terms: “cleft lip,” “cleft palate,” “cleft lip and palate,” “cleft surgery,” and “cleft repair” from January 2004 to January 2021. Relative search volumes (RSV) recorded for the top 5 highest displaying countries and top 3 available regions within those countries were compared against global outreach by Operation Smile and Smile Train, as measured by the number of patients treated. World Health Organization (WHO) indicators were used to validate the RSV values for each country and better understand the current infrastructure and need for cleft care in those countries. Globally, there was an increase in RSV for the terms “cleft lip,” “cleft palate,” “cleft repair,” and “cleft surgery” between 2004 and 2021. For “cleft lip,” the countries with the highest displaying RSVs included: Ghana (100%), Zimbabwe (97%), Nepal (78%), the Philippines (64%), and Kenya (52%). Countries with high RSVs and moderate to high WHO indicators included Ghana, Kenya, India, Nigeria, and Zimbabwe. Countries with high RSVs and poor WHO indicators included Nepal and Pakistan. Some countries had specific regions with high search demand that are not currently targeted for global outreach. Using Google Trends’ data may help find more feasible locations and targeted care for efforts in global outreach with better patient awareness and turnout where demand for CL/P is increasing.

JOB LEWIS SMITH ON MATERNAL IMPRESSIONS AS A CAUSE OF CLEFT LIP AND PALATE (1890)

PEDIATRICS ◽  
1981 ◽  
Vol 68 (4) ◽  
pp. 483-483
Author(s):  
T. E. C.
Keyword(s):  
New York ◽  
Cleft Palate ◽  
Congenital Malformations ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Seventh Edition ◽  
Pediatric Society ◽  
Firm Believer

Job Lewis Smith (1827-1897), a founder of the American Pediatric Society and who, with Abraham Jacobi, established pediatrics as a specialty in our country, was a firm believer that strong mental impressions during pregnancy might be a cause of congenital malformations. He gave the following explanation of the cause of cleft lip and palate in the seventh edition of his textbook, published in 1890.1 Mrs. D[unknown], Eighth avenue, New York, seven months before the birth of her child, when visiting at a distance, accidentally broke the plate of a full set of upper teeth. The line of fracture was antero-posterior and through the centre of the plate. Being away from home, she was much annoyed by the accident and retained the fragments of the plate in situ by pressure with the tongue. As she could not open her mouth without the plate falling out, except it was retained by pressure with the tongue, her mind was dwelling almost constantly on the accident during the few days of her visit. Her boy, born seven months subsequently, had a hare-lip and cleft palate. The mother stated that the deficiency in the lip and palate corresponded precisely to the location of the fracture in the plate.

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