A study into weight gain in infants with cleft lip/palate.

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.