Cleft palate late diagnosis
Over a quarter of babies with a cleft palate have their condition missed at birth
13th December 2012 - A new report from the Royal College of Surgeons (RCS) has found an unacceptably high number of babies with a cleft palate are being diagnosed late.
It claims that national standards say clefts should be diagnosed within 24 hours of birth to enable immediate referral to a specialist hospital. However, the report found that 28% of babies with a cleft that affects the roof of the mouth alone are diagnosed outside this target, with 5% remaining undiagnosed until after they're a month old.
Early diagnosis is important as a baby with a cleft palate may be unable to breastfeed and will need bottles with specially adapted teats. Rosanna Preston, CEO of the Cleft Lip and Palate Association (CLAPA), says in a press statement: "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."
Craniofacial abnormalities such as a cleft lip and/or palate are among the most common of all birth defects, affecting over 1000 babies in the UK each year. The exact cause of clefts isn't known. Often a baby is diagnosed with a cleft lip while still in the womb but a cleft of the palate is rarely identified on a scan.
A cleft lip can range from a slight notch in the coloured part of the upper lip to complete separation on one or both sides of the lip, and extending up to the nose.
A cleft palate is not as noticeable as a cleft lip because it is inside the mouth. It occurs when the roof of the mouth does not completely close, leaving an opening that can extend into the nose above. Cleft lip and cleft palate often occur together, both can be treated surgically within the first year of life.
Although only 71% of cleft palates were identified at birth in 2011 in England, Wales and Northern Ireland, this is a 4% improvement on the previous year.
The RCS says further progress is necessary. It's urging that babies are checked thoroughly at the first opportunity to identify a cleft palate and it's calling for guidelines on examining newborns to be reviewed to reduce the risk of a missed diagnosis.
Consultant orthodontist, Scott Deacon, who helped prepare the RCS report says in a press release: "We rely on the roof of our mouth to eat, talk and do many other things we take for granted. A cleft palate is a serious condition as it can leave babies unable to feed and gain weight; it can also be indicative of other health problems. It is crucial that a thorough visual examination of the mouth and palate is carried out within 24 hours of birth to ensure the baby, and their family, receives the care and support they need from the outset."