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

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. 1. Introduction Cleft lip and palate is the most common craniofacial malformation and is often associated with swallowing impairment and decreas growth rate, likely secondary to children’s inability to feed appropriately [1]. According to the literature, children with either cleft lip or palate have a short, fast, uncoordinated, and ineffective intraoral suction, which may cause asphyxia, the entrance of milk in the nose cavity, and as excessive air ingestion [2, 3]. The cleft is considered the main anatomic issue leading to these dysfunctions. In fact, studies showed that children with clefts have lower height and weight when compared to a control group, especially during the first year of life [4–6]. On the other hand, Mcheik and Levard report that the growing curves of children with cleft palate, and regular children are equivalent if patients have no syndrome or severe malformations associated [7]. Consequently, the growing pattern might be more influenced by external factors, such as parents’ adaptation to the children’s condition or the feeding method used [8]. Adjustments on the care of these children may be helpful to assure appropriate nutrition and significant weight gain [9]. Therefore, the main priority during the first months of life,