We have started an early supporting system at the medical and educational handicap center in Kitakyushu city for cleft lip and/or palate babies and their mothers from 1984. In this study, we explained this system and in particular discussed the family counselling performed just after the babies with cleft lip and/or palate (CLP) were born. We obtained several findings at the first examination about the methods of feeding milk, the body growth (the Kaup Index), the experience of nasal tube feeding and so on.
The results were as follows.
1) 118 babies with CLP accepted the early supporting system and 44 of the 118were within 1 month old after birth at the first examination.114 of the 118babies used the Hotz plate.
2) Concerning the main complaint,46 babies (about 40% of the total) had feeding difficulties. As for the types of referrals, many cases were refered from the NICU of the hospitals and the maternal hospitals in Kitakyushu city and Shimonoseki city in Yamaguchi prefecture.
3) The percent of the babies who had experienced nasal tube feeding at birth was 33.0%. There was also no difference among the types of the cleft lip and/or palate. However the type that used the nasal tube longer than others was the cleft palate.
4) Concerning the Kaup Index,25.1 % was too thin.
5) Of the 118 babies, the families of 39 babies accepted the family counselling.3 cases of family counselling were performed just on the day of birth,16 cases on the 2nd day and 37 cases until the 10th day. There were 16 cases in which parents attended the counselling. There were 13 cases in which parents and other relatives and 6 cases in which just the mother attended.
6) There were 58 questions in the family counselling about speech, the operations of cleft lip and/or palate, the Hotz plate, the development of the teeth and the occlusion, the genetics of the cleft and so on. Of the questions posed by the families, there were more questions about speech than about the operation of the cleft.
The above results suggest the usefulness of the team approach containing developmental evaluations by specialists (e. g. the pediatrician, the orthopedician the oculist and the motor therapist) for the treatment of the babies with cleft lip and/or palate.