Sir: Poor weight gain, decreased growth, and an elevated prevalence of failure to thrive are often experienced by infants with cleft lip and/or palate and do not end with successful surgical repair.1 Data on the growth of cleft patients into their later childhood and adolescence are relatively less available. The present study represents an investigation of the growth of cleft children ranging from infancy to early adulthood. Specifically, body mass index was used as an anthropomorphic measurement to compare patients with clefts to normative data to determine whether individuals born with isolated cleft deformities go on to have body mass indexes that differ from those of their unaffected peers. Three hundred eighteen patients with cleft lip and/or cleft palate were identified and their medical records were retrospectively examined. Patients aged 2 to 21 years with isolated cleft lip and/or palate were eligible for the study, whereas those with syndromes or sequences or karyotype abnormalities, or those without at least two measurements from the 0- to 10-year-old and 10- to 20-year-old age groups were excluded. Body mass index was calculated and used as the primary anthropomorphic measurement. To compare body mass indexes to normative values across the varying ages, a z score for each measurement was calculated using Epi Info based on the Centers for Disease Control and Prevention's clinical growth charts published in the year 2006. A body mass index z score greater than 0 indicates length to weight for age greater than that of the general population, and less than 0 indicates lower than that of the general population. Data were analyzed both by descriptive statistics (mean body mass index z score) and by means of t test both for the entire patient population and for stratifications on the basis of age, gender, and type of cleft. A total of 59 patients were identified for inclusion in our analysis. The mean body mass index z score for all patients was 0.117. Patients were stratified by gender, with male patients having a mean z score of 0.087 and female patients a mean z score of 0.160, a statistically insignificant difference (p = 0.407). When stratifying by age, patients younger than 10 years possessed a mean z score of 0.208, and patients older than 10 years had a mean z score of –0.028 (p = 0.223). The overall results of our study suggest that, on average, patients with isolated clefts do not have a deficit with regard to their body mass index during childhood and adolescence relative to the general population. Multiple studies have shown that cleft patients experience decreased growth and increased failure to thrive in the early years of life.2 The reasons for this are multifactorial, with feeding difficulties early in life being a primary contributory factor.3 Our results suggest that these growth difficulties experienced by cleft patients early in life do not persist into later ages. Although statistical significance was not reached (and thus we cannot draw absolute conclusions between groups), our results do provide necessary preliminary conclusions for a potentially larger prospective study of body mass indexes among patients with clefts throughout childhood and adolescence. DISCLOSURE The authors have no financial interests to declare. Peter F. Koltz, M.D. Jacob Bloom, M.D. Hani Sbitany, M.D. Robert A. Fargione, B.A. John A. Girotto, M.D. Division of Plastic Surgery University of Rochester Medical Center Rochester, N.Y.