Belfast Telegraph

Friday 19 September 2014

Too many cleft palates 'found late'

The Royal College of Surgeons said some maternity units are better than others at identifying cleft palates during newborn examinations

A high number of babies with a cleft palate are being diagnosed late, a report has found.

A report from the Royal College of Surgeons (RCS) revealed that some maternity units are better than others at identifying clefts during the newborn examination. For example, only 42% of cleft palates were identified within 24 hours of birth in the North Thames area, whereas more than 94% were identified at birth in the Oxford area.

National standards state that clefts should be diagnosed within 24 hours of birth to enable immediate referral to a specialist hospital. The report found that 28% of babies with a cleft that affects the roof of the mouth alone are diagnosed outside of this target, with 5% remaining undiagnosed until after one month of age.

Although only 71% of cleft palates were identified at birth in 2011, this is 4% higher than in 2010 when one third of babies with a cleft palate had their condition missed at birth.

Rona Slator, consultant plastic surgeon and clinical director of West Midlands Cleft Service, said: "A cleft has wide-ranging implications for a child's health, and is certainly not just an aesthetic condition.

"All babies with a cleft will need surgical treatment once they are old enough, but prior to this the newborn, and their family, will require special bottles, guidance and help with feeding. "Early diagnosis really is imperative."

The report warned that delay in diagnosis results in avoidable distress for families as babies are left unable to feed and gain weight.

Craniofacial abnormalities such as a cleft lip or palate are among the most common of all birth defects, affecting over 1,000 babies in the UK each year. Of these, approximately 45% have a cleft affecting only the palate. Unlike other types of cleft which affect the lip, identification of a cleft palate is extremely difficult through an ultrasound examination during pregnancy, with only 1% diagnosed this way.

Rosanna Preston, chief executive of the Cleft Lip and Palate Association (CLAPA), said: "For any parent, noticing that your baby is not eating, feeding properly or gaining weight is terribly worrying.

"Many parents will initially blame themselves until the cause is found and worries about their baby's health can affect those crucial early days of bonding; the sooner they can get support the better."

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