Looking For Clues To Help Treat Cleft Lip And Palate | Action Medical Research

Looking For Clues To Help Treat Cleft Lip And Palate

12 June 2002

Every 11 minutes a child is born somewhere in the world with a cleft lip or palate. It is one of the most common craniofacial defects, and can lead to major medical and psychological problems for both the child and its family. Medical research charity Action Research is now investigating the benefits of existing treatment for this common but distressing birth deformity.

A London-based research team is turning detective, and hoping to set the record straight regarding a method known as ‘baby plates’. Baby plates are small acrylic plates which are sometimes fitted inside the mouth of babies with a cleft palate. It goes in within a few days of birth and the baby continues to wear the plate until surgery. The plates are said to improve feeding and facial growth, and to assist surgery and speech development by narrowing the cleft gap. But opinion among professionals is split over the effectiveness of these plates. Miss Anthea Masarei is a speech and language therapist at London’s Great Ormond Street Hospital, and is being funded to work full-time on the new project. She says: ‘There has been no hard evidence to support reports that baby plates do actually achieve the feeding and speech claims. We are looking to identify the scientific evidence to justify these.

‘The research study could potentially have an important impact on clinical practice and the management of babies with cleft lip and palate.’ By assessing babies with and without baby plates, the researchers will look at whether the plates really do benefit feeding and early speech development. The funding of more than £40,000 is further commitment from the leading medical research charity Action Research, which is famous for its efforts to help overcome disease and disability and is currently celebrating its exciting 50th anniversary. More than two years ago Action Research funded the same team more than £94,000.

The new grant will extend the researcher’s work further and enable more babies to be recruited to the study. Only recently, news reports suggested that there has been a rise of 50 per cent over the last five years in birth defects including cleft lip and palate. The condition occurs when there is either an opening between the mouth and the nose (which can look as though there is a split in the lip), or a small gap in parts of the mouth. In some cases the baby is born with both. Cases can vary in severity, but it’s not known why they occur. There is currently, therefore, no way to prevent babies developing cleft palate, explains Dr Masarei. However, the condition can be repaired by surgery during the first year of life with excellent results. In the meantime, some cleft lip and palate teams recommend fitting babies with the plates. This decision is based on personal preference and the protocol of regional teams, with some hospitals routinely prescribing them, and others not. Costing about £3000 each, an average of 300 baby plates are fitted each year. The research team is from the North Thames Regional Cleft Lip and Palate Unit, which is based at the Speech and Language Therapy Department and the Maxillo-Facial and Dental Department, Great Ormond Street Hospital, and will be working in conjunction with London’s Institute of Child Health. Action Research is committed to helping people of all ages overcome disease and disability.

The last stage of the charity’s Touching Lives Campaign aims to raise £2.5m in 2002 for vital medical research and more details can be found at www.action.org.uk Fact-file: *Cleft lip and palate affects one in 500-700 births in the UK. *Babies are randomly allocated at birth, either to a treatment group (with baby plate) or to a non-treatment group (no baby plate) and then assessed for progress at intervals up to the ages of two years. *How well babies feed and the co-ordination of their respiration, sucking and swallowing, will be evaluated through standardised rating scales and a specially designed non-invasive feeding assessment technique. *Speech development is also assessed and recorded by video at nine months, 18 months and two years. These are made through parent interview and observation of the child at play, with rating of their speech and communication skills according to their age. *All mothers of babies recruited to the study attend hospital appointments every two to four weeks.

For further information and interviews, please contact Nicole Duckworth or Victoria Rayment in the Action Research press office on 01403 327403/404 Fax: 01403 210541, or email nduckworth@action.org.uk ISDN facilities are available.

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