Incidence of use of acid suppression medications in infants with oral clefting.
OBJECTIVE
Less than 1% of the general pediatric population needs pharmacologic therapy for reflux symptoms; yet, the co-existence of gastroesophageal reflux disease (GERD) with oral clefting remains unclear. The purpose of this retrospective study was to appreciate the difference in the incidence of anti-GERD pharmacotherapy in a sample population of infants with oral clefting compared to the general pediatric population.


METHODS
One hundred ninety-six consecutive patients diagnosed with cleft lip only, cleft lip and palate, and isolated cleft palate were analyzed through clinical record review. Demographic and clinical information including but not limited to the type of oral cleft present at birth, reported signs and symptoms of GERD, and anti-GERD medications used were compiled for all subjects. Collected data were analyzed using descriptive statistics.


RESULTS
Sixty-four (33%) of 196 infants with oral clefts had documented signs and symptoms of GERD. Nine percent (18 of 196) of the subjects received anti-GERD medications. The infant subgroup with treated GERD consisted of 11 out of 62 (18%) patients with isolated cleft palate, 5 of 112 (4.5%) with cleft lip and palate, and 2 of 17 (11%) with cleft lip only.


CONCLUSIONS
The incidence of anti-GERD pharmacologic therapy among infants with oral clefts (9%) is significantly higher than among the general pediatric population (<1%). Furthermore, palatal clefts impart a greater risk of GERD symptoms than clefts of the alveolus, lip, or nose. In order to minimize the long-term consequences of GERD, a standardized interdisciplinary clinical protocol is necessary for evaluating infants with oral clefts.
Koltz
Peter F
PF
University of Rochester Medical Center, Plastic and Reconstructive Surgery, Rochester, New York, USA. Peter_Koltz@urmc.rochester.edu
Albino
Frank P
FP
Hyatt
Brad
B
Fargione
Robert A
RA
Katzel
Evan
E
Girotto
John A
JA
D000402:Airway Obstruction / Q000175:diagnosis; D000863:Antacids / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D003371:Cough / Q000175:diagnosis; D003490:Cyanosis / Q000175:diagnosis; D005183:Failure to Thrive / Q000175:diagnosis; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D014839:Vomiting / Q000175:diagnosis
D000863:Antacids; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors