Changing Faces, Changing Lives

Faltering Growth in Cleft Lip/Palate: How Far Have We Come?

Research Title

Faltering Growth in Cleft Lip/Palate: How Far Have We Come?

Lead Author

Ms Nitisha Narayan (Craniofacial Australia-funded researcher)

Published in

The Journal of Craniofacial Surgery

At a glance

The study examined data from the UK’s large-scale Cleft Collective research cohort to understand how common faltering growth remains in children born with cleft lip and palate, despite significant improvements in cleft care over recent decades.

What Did the Research Find?

The researchers found that:

  • Around 29% of children with cleft lip and/or palate experienced faltering growth in early life.
  • Feeding difficulties remain a significant challenge for many babies born with cleft conditions.
  • Children with more complex cleft presentations were at greater risk of poor growth.
  • Although outcomes have improved substantially since cleft services were centralised and specialist cleft teams were introduced, growth concerns have not been eliminated.

Why Does This Matter?

Babies with a cleft palate often struggle to create the suction needed for feeding. As a result, they can take longer to feed, tire more easily, and may not receive enough nutrition to gain weight appropriately.

Poor weight gain is more than just a number on a growth chart. It can:

  • Delay surgery if a baby is not strong enough for an operation.
  • Affect recovery and wound healing after surgery.
  • Increase stress and anxiety for parents already navigating a complex diagnosis.
  • Lead to additional medical appointments and interventions.

What Does This Mean for Families?

This research highlights that while surgical techniques and clinical care have improved dramatically, families still need practical feeding support from the moment their baby is born.

For families, the findings reinforce the importance of:

  • Early access to specialist cleft nurses and feeding experts.
  • Ongoing monitoring of growth and nutrition.
  • Access to trusted information and support services.
  • Emotional support during what can be an overwhelming period.

Key Takeaways

  • This research provides strong evidence that support services remain critically important. While surgeons and clinicians repair the cleft, families often need help navigating the practical realities of feeding, hospital visits, travel, accommodation, and the emotional toll that comes with caring for a baby with complex needs.
  • The findings also help identify which children may be at higher risk of faltering growth, creating opportunities for earlier intervention and better long-term outcomes.
  • Nearly one in three children with cleft lip and/or palate still experience faltering growth in early life. This research shows that despite major advances in cleft care, feeding difficulties remain a significant challenge, highlighting the ongoing need for specialised clinical care and family support services.

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