Presentation Weight Indices for Patients with Cleft and Non-Affected Children: A Two-Centre Study

BACKGROUND: Children with cleft lip and/or palate (CL/P) face many challenges in the society. They tend to suffer malnutrition and therefore poor weight gain due to lack of standard care, especially from their parents and society at large. The poor weight gain leads to delayed surgical repair of the cleft abnormality leading to prolonged nutritional and psychological challenges for all concerned. OBJECTIVE: The aim of the study was to determine if children without cleft abnormalities presenting for routine immunisation and children with cleft abnormalities are both likely to be less than the 75(th) percentile of expected weight at the time of presentation, and if there is any difference in presenting weight amongst children with different cleft types. MATERIALS AND METHODS: This was a retrospective study. Data of children that attended the immunisation clinic of the Department of Primary Health of the National Orthopaedic Hospital, Enugu, and routine surgical clinic of the National Orthopaedic Hospital, Enugu, Nigeria, and the Good Shepherd Specialist Hospital, Enugu, Nigeria, between January 2010 and December 2014 with a diagnosis of CL/P, were obtained from the medical records. The data were analysed with SPSS and the confidence interval was 95%. RESULTS: A total of 923 medical records were reviewed for the study, out of which 363 were for children with cleft abnormalities. There was no significant difference in the weight of the children without cleft and presenting for routine immunisation compared with their expected 75(th) percentile, or children with cleft abnormality compared with their expected 75(th) percentile (either in their first or in their second visits). With the children that presented with CL/P, there was a significant difference noted amongst children with both CL/P deformity with the expected 75(th) percentile weight, irrespective of whether the combination was unilateral or bilateral, with P = 0.041. This difference was noted in their first visit. CONCLUSION: Children with combined CL/P are at risk of presenting with poor weight. Nutritional rehabilitation considered early with children with cleft and particularly those children with combined CL/P.