The Primary Care Pediatrician and the Care of Children With Cleft Lip and/or Cleft Palate

Pediatrics. 2017 May;139(5):e20170628. doi: 10.1542/peds.2017-0628.

Abstract

Orofacial clefts, specifically cleft lip and/or cleft palate (CL/P), are among the most common congenital anomalies. CL/P vary in their location and severity and comprise 3 overarching groups: cleft lip (CL), cleft lip with cleft palate (CLP), and cleft palate alone (CP). CL/P may be associated with one of many syndromes that could further complicate a child's needs. Care of patients with CL/P spans prenatal diagnosis into adulthood. The appropriate timing and order of specific cleft-related care are important factors for optimizing outcomes; however, care should be individualized to meet the specific needs of each patient and family. Children with CL/P should receive their specialty cleft-related care from a multidisciplinary cleft or craniofacial team with sufficient patient and surgical volume to promote successful outcomes. The primary care pediatrician at the child's medical home has an essential role in making a timely diagnosis and referral; providing ongoing health care maintenance, anticipatory guidance, and acute care; and functioning as an advocate for the patient and a liaison between the family and the craniofacial/cleft team. This document provides background on CL/P and multidisciplinary team care, information about typical timing and order of cleft-related care, and recommendations for cleft/craniofacial teams and primary care pediatricians in the care of children with CL/P.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cleft Lip / diagnosis
  • Cleft Lip / epidemiology
  • Cleft Lip / etiology
  • Cleft Lip / therapy*
  • Cleft Palate / diagnosis
  • Cleft Palate / epidemiology
  • Cleft Palate / etiology
  • Cleft Palate / therapy*
  • Dental Care for Children
  • Humans
  • Infant
  • Infant, Newborn
  • Oral Health
  • Patient Care Team
  • Pediatrics*
  • Physician's Role*
  • Prenatal Diagnosis
  • Primary Health Care*
  • Referral and Consultation