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Clearer guidance needed to ensure cleft palates diagnosed within 24 hours of birth

A medical negligence expert has called for clearer guidance for medical professionals to help diagnose a cleft palate in babies within 24 hours of birth.

Newborn baby in hospital

5 September 2017

Guidelines provide that cleft palates, which affect over 1,000 babies a year in the UK, should be diagnosed within 24 hours of birth. This allows quick referral to a team of experts including surgeons, nurses, orthodontists and speech and language therapists and repair of the cleft palate within 6-12 months of birth. 

Late diagnosis and repair of a cleft palate can lead to developmental delay, behavioural problems and speech, language and hearing difficulties.

Data from the Cleft Registry and Audit Network (CRANE) shows that in 2015 more than a quarter of babies born with a cleft palate were diagnosed late according to the national standard of diagnosis within 24 hours.

Specialist medical negligence solicitors, Emmalene Bushnell and Kriya Amin, are investigating a claim on behalf of a child whose cleft palate was missed at birth by the NHS Hospital where he was born. It was then repeatedly missed by other health care providers despite regular attendance to his GP, health visitor and other NHS hospitals with poor feeding and weight gain. His cleft palate was finally diagnosed when he was aged 2 years and 1 month and surgery performed at 2 years and just under 3 months. 

As a result the child suffered from speech and language difficulties particularly in respect of communication and behavioural problems leading to a delay in learning and dysphonia, which was both frustrating and challenging for him to cope with at such a young age. His parents suffered significant anxiety in the years leading up to his diagnosis, particularly as they were never given any inclination from medical professionals that their son’s ongoing problems could have been related to a medical issue.

Cleft palates can occur because in early pregnancy different parts of the infant’s face develop individually and subsequently join together. If some parts of the face do not join properly, the infant is born with a cleft.

Cleft lips and palates are the most common craniofacial abnormalities. A cleft palate is a gap in the roof of the mouth leading to difficulties sucking adequately and trouble feeding. Speech, language and hearing difficulties can also develop as a result of a cleft palate.

A cleft palate is almost impossible to pick up before birth through regular scans, and can be easily missed when a baby is born if it is not looked for.  

Kriya Amin, Solicitor in the Clinical Negligence department at Leigh Day said:

“Clearer guidance on the visual and procedural technique to examine a baby’s mouth for palatal defect following birth is essential to not only avoid developmental delay and speech, hearing and language difficulties for the child but also the anxiety and distress of their parents.”

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