Authors (including presenting author) :
Yim SW (1)
Affiliation :
(1) Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital
Introduction :
Cleft palate and lips are among the most common congenital anomalies. The prevalence in Hong Kong is around 1.5 per 1000 live births. In the public section in Hong Kong, the cleft team in Hong Kong Children’s Hospital serves a good number of patients with cleft lips and cleft palates.
While many of them were associated with other congenital anomalies, infants with cleft lip and cleft palate are also at risk of developing feeding problems and faltering growth. Therefore, different specialties and allied health will likely to be involved in the care of these infants. So the families would need to attend different clinics and training sessions at different time and possibly different places as well. Since the commencement of the multidisciplinary integrated cleft service in Hong Kong Children’s Hospital (HKCH), infants could be assessed by different professionals and receive trainings at one stop. At each visit, patient will be assessed by our cleft team which includes paediatric surgeons, paediatricians, otorhinolaryngologists, dental surgeons, speech therapists, occupational therapists and dieticians. This not only saves the families’ time and promote satisfactions, it also provides a better ground for communications between different specialties and allied health during the joint assessments. This in turn may lead to better outcomes including feeding and growth of this group of infants.
Objectives :
To assess the prevalence and characteristics of associated anomalies in infants with cleft lip and cleft palate in HKCH and to evaluate the effectiveness of the multidisciplinary integrated cleft lip and palate service in HKCH by assessing the feeding and growth of the infants at different time points during follow ups.
Methodology :
The data and characteristics of infants with cleft lip and palate followed up in HKCH were prospectively collected upon their visits from October 2019 to December 2021. The associated anomalies would be documented in the notes written for their out-patient visits. The feeding performance and growth parameters would be assessed at different time points including the first visit, 3 months, 6 months, 9 months and 1 years old as well as peri-operative period. The growth parameters would be compared with normal population. Failure to thrive or suboptimal growth would be defined as body weight less than 10th percentile or falls off from patients’ own growth curve for more than one percentile line.
Result & Outcome :
There are around 100 cases being seen during this period. Around 30% of them had feeding or weight gain issues and were seeing allied health for assessment and training. Around half of them have other anomalies. At the time points of assessment of growth, most of them were able to have normal growth or following own growth velocity, including those started with suboptimal feeding performance and poor growth initially. This concludes that the multidisciplinary approach in the cleft service in HKCH is efficient and effective, especially in the aspects of feeding and growth of the infants.
