1
|
Becker de Oliveira L, Fonseca-Souza G, Rolim TZC, Scariot R, Feltrin-Souza J. Breastfeeding and Cleft Lip and Palate: A Systematic Review and Meta-Analysis. Cleft Palate Craniofac J 2024; 61:1344-1355. [PMID: 37078146 DOI: 10.1177/10556656231170137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE To evaluate the association between cleft lip and/or cleft palate (CL/P) and breastfeeding (BF). DESIGN A systematic review and meta-analysis were performed based on studies published in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, BBO, and Embase databases, and in the gray literature. The search occurred in September 2021 and was updated in March 2022. Observational studies evaluating the association between BF and CL/P were included. Risk of bias was analyzed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted. Certainty of evidence was evaluated using the GRADE approach. MAIN OUTCOME MEASURE(S) Frequency of BF in relation to the presence or absence of CL/P, as well as to the type of CL/P. The association between cleft type and BF challenges was also evaluated. RESULTS From a total of 6863 studies identified, 29 were included in the qualitative review. Risk of bias was moderate and high in most studies (n = 26). There was a significant association between the presence of CL/P and absence of BF (OR = 18.08; 95% CI 7.09-46.09). Individuals with cleft palate with or without cleft lip (CP ± L) had a significantly lower frequency of BF (OR = 5.93; 95% CI 4.30-8.16) and a significantly higher frequency of BF challenges (OR = 13.55; 95% CI 4.91-37.43) compared to individuals with CL. Certainty of the evidence was low or very low in all analyses. CONCLUSION The presence of clefts, especially those with palate involvement, is associated with higher chances of absence of BF.
Collapse
Affiliation(s)
- Luiza Becker de Oliveira
- Department of Stomatology, Universidade Federal do Paraná, Setor de Ciências da Saúde, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná 80210-170, Brazil
| | - Gabriela Fonseca-Souza
- Department of Stomatology, Universidade Federal do Paraná, Setor de Ciências da Saúde, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná 80210-170, Brazil
| | - Tatiane Zahn Cardoso Rolim
- Department of Stomatology, Universidade Federal do Paraná, Setor de Ciências da Saúde, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná 80210-170, Brazil
| | - Rafaela Scariot
- Department of Stomatology, Universidade Federal do Paraná, Setor de Ciências da Saúde, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná 80210-170, Brazil
| | - Juliana Feltrin-Souza
- Department of Stomatology, Universidade Federal do Paraná, Setor de Ciências da Saúde, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná 80210-170, Brazil
| |
Collapse
|
2
|
Penny C, Nugent KA, Gilgan H, Bezuhly M. Comparison of two Specialized Cleft Palate Feeders. Cleft Palate Craniofac J 2024; 61:443-449. [PMID: 36217739 PMCID: PMC10893773 DOI: 10.1177/10556656221129977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate feeding efficiency and weight gain in infants with cleft palate fed using 1 of the 2 specialty feeders. DESIGN Retrospective cohort study. SETTING Cleft palate clinic in a tertiary pediatric hospital. PARTICIPANTS Infants with cleft palate (with or without cleft lip) fed using the Medela SpecialNeeds® Feeder (n = 39) or the Dr. Brown's® Specialty Feeding System (n = 16) and who had documented feeding and growth data available from the time of initial assessment in the first month of life and at subsequent follow-up between 2 and 4 months. PRIMARY OUTCOME MEASURE Feeding velocity (mL/min). SECONDARY OUTCOMES MEASURES Calorie velocity (kcal/min), weight gain, and complications associated with poor feeding. RESULTS No statistically significant differences in feeding or calorie velocities were identified between infants with cleft palate fed with the Medela SpecialNeeds® feeder and those fed with the Dr. Brown's® feeder. Mean weight z-scores by month did not differ significantly between the 2 bottle groups at the time of initial assessment (P = .84) and follow-up (P = .20). Mean weight z-scores by month for the infants included in this study fell below the 50th percentile. The proportion of infants who developed otitis media, reflux requiring treatment, or who required hospital admission for nasogastric (NG) feeds did not differ significantly between the 2 groups. CONCLUSIONS Despite being adequately powered for the primary outcome, no significant differences were identified between infants fed with the Medela or the Dr. Brown's feeders in terms of feeding velocity, calorie velocity, weight gain, or complications.
Collapse
Affiliation(s)
- Cameron Penny
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Michael Bezuhly
- Division of Plastic Surgery and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
3
|
Alqadi S, Qazali A, Altamimi R, Altamimi R, Abdouh I, Othman A, Abdulhameed F. Perception and Attitude of Parents of Children With Orofacial Clefts Regarding the Use of Presurgical Orthopedics and Feeding Obturators. Cureus 2023; 15:e46131. [PMID: 37779676 PMCID: PMC10538351 DOI: 10.7759/cureus.46131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE This study aims to evaluate the parents' attitude and their perception regarding the management of orofacial cleft (OFC) children with presurgical nasoalveolar molding (PNAM), DynaCleft and/or feeding obturators. MATERIAL AND METHODS A cross-sectional, descriptive and observational retrospective survey-based study was conducted among parents of OFC children treated with PNAM, DynaCleft and/or feeding obturators who attended a primary dental health care center in Al-Madinah, Saudi Arabia, from 2019 to 2023. A validated questionnaire was used after translating it from English to Arabic. The questionnaire consisted of 32 questions divided into two sections. The first section covers parents' sociodemographic data and OFC risk factors. The second section evaluates the parents' perception regarding the use of presurgical orthopedics (PSO) for OFC repair. The questionnaire was completed through telephone interviews carried out by two investigators with the parents of OFC children. RESULTS Out of 142 parents of OFC children, only 40 parents and their children met the inclusion criteria of the study. Most parents (95%) reported their satisfaction with the treatment and stated that they would encourage other parents of OFC children to use PSO. CONCLUSION This study concluded that parents of OFC children had a positive attitude toward PSO treatment. Based on the positive outcomes of PSO treatment reported in the current study and previous literature, PSO should be considered as a routine treatment in the early management of orofacial clefts.
Collapse
Affiliation(s)
- Soha Alqadi
- Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Ahmad Qazali
- Prosthodontics, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Raghad Altamimi
- General Dentistry, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Rahaf Altamimi
- General Dentistry, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Ismail Abdouh
- Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Ahmad Othman
- Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, SAU
| | - Fatma Abdulhameed
- Pediatric Surgery, King Salman Bin Abdulaziz Medical City, Al-Madinah Al-Munawwarah, SAU
| |
Collapse
|
4
|
Thompson RL, Thorson HL, Chinnadurai S, Tibesar RJ, Roby BB. Prenatal Consultation Outcomes for Infants With Cleft Lip With and Without Cleft Palate. Cleft Palate Craniofac J 2023; 60:1071-1077. [PMID: 35437035 DOI: 10.1177/10556656221093174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
To assess the clinical impacts of prenatal consultation with a multidisciplinary cleft team on infants with cleft lip with or without cleft palate (CL ± P). Retrospective cases series. Tertiary pediatric hospital. Infants with CL ± P whose mothers received prenatal consultation with a pediatric otolaryngology team from June 2005 to December 2019 were identified. A random sample of infants with CL ± P without prenatal consultation from June 2005 to December 2019 was also identified. The primary outcomes were the length of hospitalization during the first 12 weeks of life, timing of surgical repair, length of postsurgical hospitalization, and number of unplanned clinic visits and phone calls for feeding evaluation. Time to cleft lip repair differed significantly between the 2 groups with repair performed at 13.4 (±0.9) weeks for the prenatal consultation group (n = 73) and 15.3 (±2.1) weeks for the control group (n = 80), (P < .05). If hospitalization was required for feeding difficulties during the first 12 weeks of life, length of stay was 4.9 (± 1.7) days for infants with prenatal consultation and 11.5 (± 7.2) days for control infants (P < .05). Unplanned clinic visits with a speech-language pathologist (SLP) for feeding difficulties were needed for 2.7% of prenatal consultation infants and 11.3% of control infants (P < .05). Prenatal consultation regarding CL ± P resulted in infants with decreased duration of early hospitalizations, earlier cleft lip repair, and decreased engagement with the SLP feeding clinic for feeding difficulties when compared with infants without prenatal consultation.
Collapse
Affiliation(s)
| | - Heidi L Thorson
- Minnesota Perinatal Physicians, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Sivakumar Chinnadurai
- Department of ENT and Facial Plastic Surgery, Children's Minnesota, Minneapolis, MN, USA
- University of Minnesota Department of Otolaryngology Head and Neck Surgery, Minneapolis, MN, USA
| | - Robert J Tibesar
- Department of ENT and Facial Plastic Surgery, Children's Minnesota, Minneapolis, MN, USA
- University of Minnesota Department of Otolaryngology Head and Neck Surgery, Minneapolis, MN, USA
| | - Brianne B Roby
- Department of ENT and Facial Plastic Surgery, Children's Minnesota, Minneapolis, MN, USA
- University of Minnesota Department of Otolaryngology Head and Neck Surgery, Minneapolis, MN, USA
| |
Collapse
|
5
|
Tahmasebifard N, Briley PM, Ellis C, Perry JL. Early Nutrition among Infants Admitted to the NICU with Cleft Lip and Palate. Cleft Palate Craniofac J 2023; 60:299-305. [PMID: 34812064 DOI: 10.1177/10556656211059371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The objective of this study was to examine differences in human milk feeding outcomes among infants admitted to a neonatal intensive care unit (NICU) with and without cleft lip and palate (CLP). METHOD Data were used from a sample of infants admitted to the NICU with and without CLP from the 2018 National Vital Statistics System. For baseline comparisons, Chi-square tests of independence were used to compare categorical variables, and independent samples t tests were used for continuous variables. Logistic regression models were performed to determine the odds of human milk feeding at discharge in infants admitted to the NICU with CLP. RESULTS The total sample included 345,429 infants admitted to the NICU, of which 660 had CLP. Significant differences were found among the following variables when baseline comparisons were made between infants admitted to the NICU with and without CLP: mother's race, mother's education, maternal smoking record, childbirth delivery method, presence of maternal pre-pregnancy diabetes, five-minute APGAR score, multiparity record (having more than one baby at birth), gestational age, and gestational weight. After controlling for baseline differences, results indicated reduced odds of human milk feeding at discharge in infants admitted to the NICU with CLP compared to those without CLP (OR = .543; 95% CI.455,.648). CONCLUSION Results suggest reduced odds of human milk feeding at discharge among infants admitted to the NICU with CLP compared to those without CLP. These findings emphasize the necessity of awareness and facilitation of human milk feeding in this population.
Collapse
Affiliation(s)
- Neda Tahmasebifard
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| | - Patrick M Briley
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, USA
| | - Jamie L Perry
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| |
Collapse
|
6
|
Ogawa A, Sasaki Y, Naruse M. An investigation into nutritional methods at the fifth day after birth of infants in association with cleft type and laterality. Congenit Anom (Kyoto) 2023; 63:74-78. [PMID: 36680745 DOI: 10.1111/cga.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 12/13/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023]
Abstract
In patients with clefts, the affection of other congenital malformations on the feeding is unclear. We investigated the other congenital malformations and nutritional intake of neonates with cleft lip and/or palate and examined their relationships associated with cleft type and laterality. The participants included 126 infants under treatment with a presurgical naso-alveolar molding (PNAM) or a Hotz-type plate. The survey items were gender, cleft type and side, presence and nature of other congenital malformations, birth weight and nutritional method at age of the fifth day. The number of infants was 36 (28.6%) of cleft lip and alveolus, 82 (65.1%) of cleft lip and palate, and 8 (6.3%) of cleft palate only. Forty-three patients (34.1%) had other various congenital malformations. The nutritional method included oral intake in 78.6% (n = 99) of cases and tube feeding with/without oral intake in 21.4% (n = 27) of cases. The rate of tube feeding was higher for right-sided clefts than that for left-sided clefts. This observation was consistent with the fact that right-sided clefts were associated with more significant other congenital malformations than those on the left-side. The nutritional method for infants with cleft lip and/or palate was related to the presence of other congenital malformations, not to cleft laterality or oral cleft itself under early treatment with PNAM plate. These results proposed that screening the general condition is essential for neonates with right-sided cleft lip with/without cleft palate compared to left-sided clefts, which should be conducted immediately after birth for planning the appropriate nutritional method.
Collapse
Affiliation(s)
- Ayano Ogawa
- Department of Pediatric Dentistry, School of Dentistry, Kanagawa Dental University, Yokosuka, Kanagawa, Japan.,Department of Dentistry, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Yasunori Sasaki
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.,Hayama Childrens' Dental Clinic, Medi-style, Incorporated Medical Institution, Hayama, Kanagawa, Japan
| | - Masahiro Naruse
- Department of Dentistry, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| |
Collapse
|
7
|
Mohapatra D, Dash M, Dash K, Nayak S. Feeding interventions among cleft lip/palate infants: A systematic review and meta-synthesis. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2023. [DOI: 10.4103/jclpca.jclpca_27_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
|
8
|
A Cross-Sectional Study of the Nutritional Status of Infants with Orofacial Clefts in the First 6 Months of Life. J Pediatr 2022; 255:181-189.e3. [PMID: 36462686 DOI: 10.1016/j.jpeds.2022.11.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE(S) To estimate nutritional status in a large cohort of infants with orofacial clefts in the US, overall and by cleft type from birth to 6 months of age. STUDY DESIGN We conducted a cross-sectional study in infants with orofacial clefts by examining growth by month between birth and 6 months of age. Infants with at least one weight measurement at a single US regional tertiary care pediatric hospital with an interdisciplinary cleft team between 2010 and 2020 were included. We calculated the average weight-for-age z scores and weight-for-length z scores. We calculated the proportion of infants underweight and wasting with z scores below -2 SDs monthly from birth to 6 months of age. We used t tests to compare the distribution of weight for age z-score and weight for length z-score among children with orofacial clefts to a normal distribution. RESULTS We included 883 infants with orofacial clefts. Compared with expected proportion of underweight infants (2.3%), a larger proportion of infants with orofacial clefts were underweight between birth and 1 month (10.6%), peaking between 2 and 3 months (27.1%), and remaining high between 5 and 6 months (16.3%). Compared with the expected proportion of infants with wasting (2.3%), a higher proportion of infants with orofacial clefts experienced wasting between birth and 1 month (7.3%), peaking between 2 and 3 months (12.8%), and remaining high between 5 and 6 months (5.3%). Similar findings were observed for all cleft types and regardless of comorbidities. CONCLUSION(S) A substantial proportion of infants with orofacial clefts compared with normative peers have malnutrition in the first 6 months of life in the US.
Collapse
|
9
|
Todorović J, Zelić M, Jerkić L. Eating and swallowing disorders in children with cleft lip and/or palate. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-30733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction. Cleft lip and palate are complex congenital anomalies of the orofacial system of children. Feeding and swallowing problems occur with varying degrees in children with cleft lip and/or palate. Aim. The aim of this paper was to review the literature and available evidence regarding the types of eating and swallowing disorders that can be identified in children with cleft lip and/or palate, as well as a description and types of compensatory strategies and interventions to alleviate difficulties. Methods. Insight into the relevant literature was performed by specialized search engines on the internet and insight into the electronic database. Results. The extent of the cleft is related to the severity of eating and swallowing disorders, so the most common problems are decreased oral sensitivity, cough, choking, nasal regurgitation, difficulty in sucking, laryngotracheal aspiration due to inadequate airway protection during swallowing, which may result in pneumonia and lung damage. Feeding and swallowing difficulty is also a source of stress for parents. Conclusion. Choking, coughing, nasal regurgitation, laryngotracheal aspiration, excessive air intake can lead to dehydration, malnutrition, but also the need for alternative feeding methods Therefore, it is of great importance to identify the problems of feeding and swallowing in a timely manner, along with modifications of the feeding method.
Collapse
|
10
|
Penny C, McGuire C, Bezuhly M. A Systematic Review of Feeding Interventions for Infants with Cleft Palate. Cleft Palate Craniofac J 2021; 59:1527-1536. [PMID: 34714161 DOI: 10.1177/10556656211051216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Various devices and techniques have been proposed to reduce feeding difficulties experienced by infants with cleft palate. The aim of this review is to identify and assess the scope and quality of evidence for these interventions. METHODS A systematic review of published literature evaluating feeding interventions for infants with cleft palate (with or without cleft lip) from database inception to 2021 was conducted using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using a methodological index for nonrandomized studies, Cochrane, or a measurement tool to assess systematic reviews 2 instruments, according to study type. RESULTS Fourteen studies met inclusion criteria, with the majority (71%) of studies consisting of second-level evidence. Included interventions were specialty bottles (21%), alternative feeding delivery systems (14%), obturators (14%), and educational programs (14%). Specialty bottles and palatal obturators did not appear to offer any substantial growth advantages compared to traditional bottles or no intervention, respectively. Designated education programs for the mothers of infants with clefts had a positive impact on infant growth. CONCLUSIONS Overall evidence evaluating feeding interventions for infants with cleft palate was moderate to low. While it does not appear that specialized feeding delivery systems or palatal obturators significantly improve growth in infants with clefts compared to children without cleft conditions, education programs do appear to be beneficial.
Collapse
Affiliation(s)
- Cameron Penny
- 12361Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | |
Collapse
|
11
|
González Jara M, Norambuena Norambuena S, Inostroza Allende F, Lennon Zaninovic L, Quezada Gaponov C, Cornejo Farías J. Caracterización de la alimentación en bebés chilenos con fisura de paladar entre 0 y 6 meses. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2021. [DOI: 10.5209/rlog.72154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Los bebés con fisura de paladar manifiestan problemas en las dinámicas de succión, debido a la comunicación entre la cavidad nasal y oral. El objetivo del estudio fue caracterizar y comparar antecedentes generales y de alimentación en bebés de entre 0 y 6 meses portadores de fisura post-foramen (FPF) y trans-foramen (FTF). Se revisaron registros de atenciones de 36 bebés portadores de FPF y FTF de un hospital público de Chile. Se compararon los datos obtenidos entre los tipos de fisura FPF y FTF usando el software estadístico R. Los días de alimentación por lactancia materna directa fueron en promedio 13.5 días en bebés con FPF y 16.6 días en bebés con FTF. Se constató desnutrición en el 72.7% de los bebés con FPF y 40% de los bebés con FTF. La fórmula láctea y el uso de biberón se presentó más del 96% de los participantes. La extracción de leche materna alcanzó los 25.2 días en FPF y 48.1 días en FTF. La indicación de métodos de extracción de leche materna, tipo de fórmula y tipo de utensilio para la alimentación fue entregada en su mayoría por un profesional. Se observó que el tiempo de lactancia materna directa fue inferior a otros centros nacionales e internacionales. En tanto, el utensilio más usado fue el biberón y las indicaciones para alimentar fueron otorgadas mayormente por profesionales. Se concluye que no existen diferencias significativas al comparar la alimentación entre ambos tipos de fisura.
Collapse
|
12
|
Yuan L, Gao Y, Pan B, Wang J, Wang Y, Gong C, Wang W, Li X. Resilience and Related Factors: A Comparison of Fathers and Mothers of Patients With Cleft Lip and/or Palate in China. Front Psychiatry 2021; 12:791555. [PMID: 35095604 PMCID: PMC8792896 DOI: 10.3389/fpsyt.2021.791555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Resilience has become a hot spot in the field of positive psychology to study life-change events. However, there were little information on resilience among the fathers and mothers of patients with cleft lip and/or palate respectively. The present study aimed to explore and compare the level and potential influential factors associated with resilience among fathers/mothers of patients with cleft lip and/or palate in China. Method: A cross-sectional study was carried out between April 2019 and July 2020 among fathers/mothers of patients with cleft lip and/or palate in two cleft lip and/or palate treatment centers in China. Sixty Nine fathers and 179 mothers of patients with cleft lip and/or palate were interviewed with a questionnaire on demographic variables and the Resilience Scale-14 (RS-14), Herth Hope Index (HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Parenting Stress Index-Short Form (PSI-SF) and Coping Health Inventory for Parents (CHIP). T-test/univariate one-way ANOVA, Pearson's r, hierarchical linear regression analysis were conducted to explore the influential factors of resilience. Results: Fathers of patients with cleft lip and/or palate had a higher level of resilience (77.77 ± 14.18) than mothers (74.52 ± 14.33) though without significance. Resilience was positively associated with hope, perceived social support, optimism and coping and negatively correlated with parenting stress both in the fathers and the mothers. Hierarchical linear regression analysis showed that hope (β = 0.400, P < 0.01), coping (β = 0.281, P < 0.05), job status, medical payments (β = -0.240, P < 0.05) were found to be associated with resilience among the fathers of patients with CL/P, and all four variables in the model could explain 42.8% of the variance in resilience; Hope (β = 0.225, P < 0.05), perceived social support (β = 0.194, P < 0.05), the age of patients (β = 0.189, P < 0.05) were found to be associated with resilience among the mothers, and all three variables in the model could explain 27.6% of the variance in resilience. Conclusion: Our study showed that, in China, fathers of patients with cleft lip and/or palate had a higher level of resilience than mothers though without significance. Hope was the only communal variable strongly associated with resilience among both the fathers and the mothers; besides, coping, job status and medical payments were found to be associated with resilience among the fathers; while perceived social support and the age of patients were found to be associated with resilience among the mothers. The results suggest that enhance hope in parents of patients with cleft lip and/or palate might greatly help improve their resilience. Besides, fathers and mothers need specific intervention to prompt their resilience.
Collapse
Affiliation(s)
- Lulu Yuan
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China.,School of Nursing, China Medical University, Shenyang, China
| | - Yuqin Gao
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Bochen Pan
- Shengjing Hospital, China Medical University, Shenyang, China
| | - Junyan Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yanjie Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Caixia Gong
- West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weiren Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, China
| |
Collapse
|
13
|
Murthy PS, Deshmukh S, Murthy S. Assisted breastfeeding technique to improve knowledge, attitude, and practices of mothers with cleft lip- and palate-affected infants: A randomized trial. SPECIAL CARE IN DENTISTRY 2020; 40:273-279. [PMID: 32388857 DOI: 10.1111/scd.12464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cleft lip and palate is one of the most common developmental anomalies affecting the craniofacial region leading to an array of problems including the inability to feed properly. OBJECTIVES This study aimed to compare the effectiveness of specially designed audio-visual module over traditional instructional module in improving the assisted breastfeeding habits. METHODOLOGY Sixteen patients received training regarding the feeding practices through the traditional instructional method, and 16 subjects received training through audio-visual module. Infants in both the groups received the standard care. These infants were followed up longitudinally for 6 months. During the follow up period, the growth parameters were recorded monthly. The knowledge, attitude, and practices of the mothers regarding feeding practices were assessed using KAP questionnaire. RESULTS There was significant improvement in the knowledge of the mothers from baseline to 6 months, however, the practices indicated that the mothers belonging to the audio-visual module group showed better understating of the condition and earlier adaptation of the breastfeeding practices. Correspondingly, the growth parameters also showed significant difference. CONCLUSION The custom-made audio-visual module would help the mothers adapt better to the stressful situation following the birth of the infant affected with cleft lip and palate.
Collapse
Affiliation(s)
- Prashanth Sadashiva Murthy
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, India
| | - Seema Deshmukh
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, India
| | - Srinivasa Murthy
- Department of Pediatrics, JSS Hospital, JSS Academy of Higher Education & Research, Mysuru, India
| |
Collapse
|
14
|
Adekunle AA, Adamson O, James O, Ogunlewe OM, Butali A, Adeyemo WL. Breastfeeding Practices Among Mothers of Children With Orofacial Clefts in an African Cohort. Cleft Palate Craniofac J 2020; 57:1018-1023. [PMID: 32295412 DOI: 10.1177/1055665620919312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To carry out a survey of breastfeeding practices and related challenges among mothers with orofacial cleft babies attending the cleft clinic of a tertiary health institution. METHODOLOGY This was a cross-sectional descriptive study using an interviewer-administered questionnaire. Sample population was all mothers of babies aged between 1 and 18 months with nonsyndromic orofacial clefts attending the cleft clinic of a tertiary health institution in Nigeria. RESULT A total of 65 mothers participated in the study. Initiation of breastfeeding was reported by the majority (83%, n = 54) of the mothers, and only 18.5% (n = 10) of this proportion continued exclusive breastfeeding. Inability of the babies to suck was reported by 46% (n = 30) of the mothers as being the most important challenge in breastfeeding. There was a significant correlation between the type of cleft and challenge in breastfeeding (Fisher exact P = .001). Sixty-three percent (n = 41) of the mothers reported they received no counseling on overcoming challenges associated with feeding their babies with a cleft at the facility where they delivered. Sixty-nine percent (n = 45) reported they first received nutritional information from the cleft clinic at presentation. The most adopted substitute for breastfeeding was the use of regular feeding bottles (n = 24, 43.6%). CONCLUSION Rate of initiation of breastfeeding for children with orofacial clefts in this African cohort is higher than reported in other populations despite the low level of nutritional counseling of the mothers after delivery.
Collapse
Affiliation(s)
- Adegbayi Adeola Adekunle
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Nigeria
| | - Olawale Adamson
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Olutayo James
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Omobolanle M Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, IA, USA
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| |
Collapse
|
15
|
Assessment of Nutrition and Feeding Interventions in Turkish Infants with Cleft Lip and/or Palate. J Pediatr Nurs 2020; 51:e39-e44. [PMID: 31324414 DOI: 10.1016/j.pedn.2019.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 05/13/2019] [Accepted: 05/16/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE The present study aimed to highlight the feeding challenges of infants with cleft lip and/or palate (CLP) that caregivers encounter and analyze the alternative interventions they perform based on their experiences in the preoperative period. DESIGN AND METHODS Parents of 200 infants with CLP were asked to complete our questionnaire. The prenatal feeding preparations, preoperative processes, and feeding challenges and modifications to overcome these difficulties were evaluated. RESULTS One-third of the caregivers stated that they had received feeding education prenatally. Sixty-five percent of the parents stated that they were not successful in breastfeeding. Infants with isolated cleft lip had minor feeding difficulties, whereas the ones with cleft palate had some major challenges such as aspiration, choking, and inadequate growth. Parents also reported that 59.5% of the infants with cleft had stayed in the intensive care units following birth. Moreover, 42% of the infants were initially fed by nasogastric or orogastric tube. Out of the 166 infants with cleft palate, 31.9% used palatal obturators. CONCLUSIONS We have reviewed the various feeding difficulties of the infants with clefts and highlighted the results of the interventions performed to overcome these difficulties for better nutrition and growth. PRACTICE IMPLICATIONS In the light of our findings, further studies should be conducted and additional educational programs should be implemented for both healthcare providers and parents to increase families' awareness regarding cleft feeding, prevent unnecessary and improper feeding interventions in infants with clefts, and alleviate the burden of feeding difficulties for both parents and infants.
Collapse
|
16
|
Wijekoon P, Herath T, Mahendran R. Awareness of feeding, growth and development among mothers of infants with cleft lip and/or palate. Heliyon 2020; 5:e02900. [PMID: 31890935 PMCID: PMC6926251 DOI: 10.1016/j.heliyon.2019.e02900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 07/16/2019] [Accepted: 11/18/2019] [Indexed: 11/01/2022] Open
Abstract
Background Awareness of feeding among mothers plays an important role in the growth and development of children with cleft lip and palate. Mothers' increased awareness provides the right care and nutrition to these children in order to grow and achieve their developmental milestones. Objectives This study aimed at (1) assessing mothers' awareness on breastfeeding and formula-milk feeding, weaning, growth, and development of infants with cleft lip and palate and (2) the relationship of mothers' awareness with their level of education and monthly household income. Methods This cross-sectional pilot study included all the mothers of infants aged up to one year who had cleft lip and/or palate attended Dental Teaching Hospital, Peradeniya between the years 2015 and 2016. Mothers of infants with oral clefts associated with other syndromic features and chronic illnesses were excluded. A pre-tested interviewer-administered questionnaire was designed to collect data. To assess the clarity of the questions, prior to the study, the questionnaire was pre-tested in 10 mothers of infants with an oral cleft but not selected for the study. Frequency distributions and descriptive statistics were used to describe study variables. Spearman Rank test was used to determine the association of mothers' awareness with their level of education and monthly household income with a 95% confidence interval. Results The sample consisted of 101 mothers who had infants born with a cleft and the response rate was 100%. Except one, all mothers reported that they have received overall feeding instructions either from a doctor, nurse, cleft center staff or a midwife. Over 65.3% of mothers were aware of feeding-related factors including; breastfeeding, formula-milk feeding, and weaning of infants with a cleft. Overall more than 80% of mothers were aware of factors related to growth and development of the child including urination, sleeping pattern, weight and growth charts. The education level of mothers was not significantly associated with mothers' awareness of any factors related to breastfeeding, formula-milk feeding, weaning and growth, and development. Further, mothers' awareness of breastmilk as the best food for babies under 6 months (p = 0.028), weaning at 4-6 months (p = 0.024), replacing milk feeds by weaning foods (p = 0.02) and not providing junk foods to infants in between main meals (p = 0.01) were significantly associated with monthly household income. Conclusions The findings of this study suggest that mothers were aware of factors related to feeding infants with a cleft lip and palate and their growth and development. The awareness of mothers about certain factors related to feeding and weaning was significantly associated with monthly household income.
Collapse
Affiliation(s)
- Parakrama Wijekoon
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka
| | - Thanuja Herath
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka
| | - Rahini Mahendran
- Smile Train Cleft Centre, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka
| |
Collapse
|
17
|
A Pilot Study of Mothers' Breastfeeding Experiences in Infants With Cleft Lip and/or Palate. Adv Neonatal Care 2019; 19:127-137. [PMID: 30325751 DOI: 10.1097/anc.0000000000000551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite the recognized importance of human milk (HM) use, breastfeeding is often discouraged for infants with cleft lip and/or palate because of their anatomical abnormalities. Poor weight gain may require formula for calorie supplementation. Stresses associated with caring for infants with cleft lip/palate may decrease rates of HM provision to these infants. PURPOSE This study investigates the experiences of mothers of infants with cleft lip/palate (CL/P) to determine choices and factors associated with providing HM to their infants. METHODS A retrospective telephone survey was administered to a cohort of mothers of infants with CL/P. RESULTS Fifty mothers agreed to participate in the survey. Most (78%) initiated use of HM for a median duration of 4 months, 32% provided HM for 6 months or more, and 79% exclusively expressed their HM. Poor supply was the most frequent challenge to providing HM and led to cessation in 46% of the mothers. Formula was used to supplement for poor supply or poor infant weight gain in 90% of the mothers. The best predictors of a mother's use of HM were child not in day care, genetic diagnosis, and gestational age at birth. Only 36% of mothers reported individual encouragement to provide HM, and 18% reported they were specifically discouraged from providing HM for their infants. IMPLICATIONS FOR PRACTICE Although initiation rates were high, there are opportunities to improve support for mothers to increase duration of HM provision in children with CL/P. IMPLICATIONS FOR RESEARCH This study establishes a baseline for future prospective studies looking at the impact of active encouragement and provision of lactation support within the cleft team setting.
Collapse
|
18
|
Gottschlich MM, Mayes T, Allgeier C, James L, Khoury J, Pan B, van Aalst JA. A Retrospective Study Identifying Breast Milk Feeding Disparities in Infants with Cleft Palate. J Acad Nutr Diet 2018; 118:2154-2161. [PMID: 30007797 DOI: 10.1016/j.jand.2018.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 05/08/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Breast milk represents the optimal substrate for all infants, including those with a cleft palate for whom growth may be compromised. OBJECTIVES Frequency of breast milk feeding at the breast and per feeder (bottle, cup, enteral tube) in infants with cleft palate was determined and compared with rates reported by the Centers for Disease Control and Prevention. A secondary aim was to review growth status of the infants. DESIGN This study represents a 5-year retrospective review using the electronic medical record. PARTICIPANTS AND SETTING Patients were ≤12 months old at the time of the initial, presurgical encounter after a diagnosis of cleft palate had been made and were treated at one of two pediatric cleft palate and craniofacial centers in Ohio between September 30, 2010, and September 30, 2015. MAIN OUTCOME MEASURES Outcomes measured were breast milk use, reported by mothers and documented in patients' electronic medical records, chronological body weight, as well as weight for length and weight-for-age z scores and percentiles. STATISTICAL ANALYSES PERFORMED Descriptive statistics included median with interquartile range and frequency with percentages. World Health Organization z scores were estimated using the Centers for Disease Control and Prevention programs for weight, weight for length, and weight for age at first visit. Comparisons of infants treated at the two hospitals were done using the Wilcoxon rank-sum test or the χ2 test. RESULTS Breast milk consumption (26 infants were breastfed and 84 received human breast milk administered with a device) was 29.5%, markedly below the 2016 Centers for Disease Control and Prevention national statistics for ever receiving breast milk (81%). Anthropometric findings included z scores of -0.95 and -0.42 for weight for age and weight for length, respectively. CONCLUSIONS Infants with cleft palate were seldom breastfed, nor was breast milk frequently used. In addition, median weight-for-age and weight-for-length z scores suggest that growth of infants with cleft palate was below normative standards.
Collapse
|
19
|
Not All Clefts Are Created Equal: Patterns of Hospital-Based Care Use among Children with Cleft Lip and Palate within 4 Years of Initial Surgery. Plast Reconstr Surg 2017; 139:1373e-1374e. [PMID: 28538587 DOI: 10.1097/prs.0000000000003377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
Reply: Not All Clefts Are Created Equal: Patterns of Hospital-Based Care Use among Children with Cleft Lip and Palate within 4 Years of Initial Surgery. Plast Reconstr Surg 2017; 139:1374e-1376e. [PMID: 28538588 DOI: 10.1097/prs.0000000000003378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Alperovich M, Frey JD, Shetye PR, Grayson BH, Vyas RM. Breast Milk Feeding Rates in Patients with Cleft Lip and Palate at a North American Craniofacial Center. Cleft Palate Craniofac J 2017; 54:334-337. [DOI: 10.1597/15-241] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Our study goal was to evaluate the rates of breast milk feeding among patients with oral clefts at a large North American Craniofacial Center. Methods Parents of patients with oral clefts born from 2000 to 2012 and treated at our center were interviewed regarding cleft diagnosis, counseling received for feeding, and feeding habits. Results Data were obtained from parents of 110 patients with oral clefts. Eighty-four percent of parents received counseling for feeding a child with a cleft. Sixty-seven percent of patients received breast milk for some period of time with a mean duration of 5.3 months (range 0.25 to 18 months). When used, breast milk constituted the majority of the diet with a mean percentage of 75%. Breast milk feeding rates increased successively over the 13-year study period. The most common method of providing breast milk was the Haberman feeder at 75% with other specialty cleft bottles composing an additional 11%. Parents who received counseling were more likely to give breast milk to their infant ( P = .02). Duration of NasoAlveolar Molding prior to cleft lip repair did not affect breast milk feeding length ( P = .72). Relative to patients with cleft lip and palate, patients with isolated cleft lip had a breast milk feeding odds ratio of 1.71. Conclusion We present breast milk feeding in the North American cleft population. Although still lower than the noncleft population, breast milk feeding with regards to initiation rate, length of time, and proportion of total diet is significantly higher than previously reported.
Collapse
Affiliation(s)
- Michael Alperovich
- Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Jordan D. Frey
- Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Pradip R. Shetye
- Plastic Surgery (Craniofacial Orthodontics), New York University Langone Medical Center and Assistant Professor of Orthodontics, New York University College of Dentistry, New York, New York
| | - Barry H. Grayson
- Surgery (Orthodontics), New York University Langone Medical Center and Associate Professor of Orthodontics, New York University College of Dentistry, New York, New York
| | - Raj M. Vyas
- Health Sciences Clinical Assistant Professor of Surgery and Director of Cleft, Craniofacial and Pediatric Plastic Surgery, University of California Riverside School of Medicine, Riverside, California
| |
Collapse
|
22
|
Management of the Amniotic Band Syndrome with Cleft Palate: Literature Review and Report of a Case. Case Rep Dent 2017; 2017:7620416. [PMID: 28246561 PMCID: PMC5299194 DOI: 10.1155/2017/7620416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/05/2017] [Indexed: 11/17/2022] Open
Abstract
Amniotic Band Syndrome (ABS) is a group of congenital malformations that includes the majority of typical constriction rings and limb and digital amputations, together with major craniofacial, thoracic, and abdominal malformations. The syndrome is caused by early rupture of the amniotic sac. Some of the main oral manifestations include micrognathia, hyperdontia, and cleft lip with or without cleft palate, which is present in 14.6% of patients with this syndrome. The purpose of this report was to describe the clinical characteristics and the oral treatment provided to a 6-month-old male patient affected with ABS with cleft lip and palate.
Collapse
|
23
|
Depla AL, Breugem CC, van der Horst CMAM, de Heus R, van den Boogaard MJH, Maas SM, Pajkrt E, Bekker MN. Polyhydramnios in isolated oral cleft pregnancies: incidence and outcome in a retrospective study. Prenat Diagn 2017; 37:162-167. [DOI: 10.1002/pd.4983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 12/04/2016] [Accepted: 12/06/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Anne L. Depla
- Department of Obstetrics and Gynecology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Corstiaan C. Breugem
- Department of Plastic and Reconstructive Surgery, Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - Roel de Heus
- Department of Obstetrics and Gynecology; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - Saskia M. Maas
- Department of Clinical Genetics; Academic Medical Center; Amsterdam The Netherlands
- Department of Pediatrics; Academic Medical Center; Amsterdam The Netherlands
| | - Eva Pajkrt
- Department of Obstetrics and Gynecology; Academic Medical Center; Amsterdam The Netherlands
| | - Mireille N. Bekker
- Department of Obstetrics and Gynecology; University Medical Center Utrecht; Utrecht The Netherlands
| |
Collapse
|
24
|
Abstract
BACKGROUND The orofacial defect of cleft lip/palate (CL/P) involves an altered physiological anatomy that affects the infant's feeding ability. Infants have cleft lip (CL), cleft palate (CP), or both (CL/P). Dysfunction in the seal, as with cleft lip, or in the ability to coordinate muscle movement to generate negative pressure, as with cleft palate, leads to feeding issues that may compromise growth and affect bonding. PURPOSE The purpose of this article is to present (1) scientific evidence that supports clinical feeding practices for the infant with CL/P and (2) teaching strategies for staff and parents. METHODS Evidence was synthesized using a narrative review of randomized controlled trials, qualitative studies, systematic reviews, professional guidelines, and position statements. Findings were used to present specialized equipment and feeding techniques to support human milk feeding. FINDINGS Special considerations for feeding infants with CL/P include assessing the infant's sucking ability, demonstrating proper breastfeeding positioning, supporting mothers to establish and maintain their milk supply, considering adaptive feeding equipment (ie, specialized bottles and nipples), and education about the benefits of human milk. IMPLICATIONS FOR PRACTICE AND RESEARCH Support from healthcare professionals, particularly lactation specialists and nursing staff, is critical. Breastfeeding and the use of human milk should be prioritized and supported. Research is needed to explore environmental, genetic, and nutritional causes (eg, folic acid deficiency) of orofacial defects.
Collapse
|
25
|
Miranda GS, Marques IL, de Barros SP, Arena EP, de Souza L. Weight, Length, and Body Mass Index Growth of Children Under 2 Years of Age With Cleft Lip and Palate. Cleft Palate Craniofac J 2015; 53:264-71. [PMID: 25554856 DOI: 10.1597/14-003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the growth of length-for-age (L/A), weight-for-age (W/A), and body mass index (BMI) of children with cleft lip and palate receiving a normal diet; to establish specific growth curves for children with cleft palate with or without cleft lip (CLP/ICP) who had not undergone palatoplasty and for children with isolated cleft lip (ICL); and to assess if CLP/ICP growth differed from ICL growth and if CLP/ICP and ICL growth differed from growth for typical children. DESIGN Prospective and cross-sectional study. SETTING Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil. MAIN OUTCOME MEASURES Weight and length of 381 children with cleft lip and palate and who were younger than 2 years were recorded and used to calculate W/A, L/A, and BMI growth curves. The 2006 World Health Organization growth charts were used as a reference for typical children. All children received a normal diet for age. RESULTS Children with CLP/ICP had median W/A and BMI growth curves below growth curves for typical children but showed spontaneous recovery starting at approximately 5 months of age, even with nonoperated cleft palate. Children with ICL had growth similar to that of typical children. Children with CLP/ICP, who initially had W/A and BMI values less than those of the ICL group, had W/A and BMI equal to or higher than the ICL group after 9 months of age. CONCLUSION Children with CLP/ICP had impaired W/A and BMI growth with spontaneous recovery starting early in childhood. This study established specific W/A, BMI, and L/A growth curves for children with cleft lip and palate.
Collapse
|
26
|
Trettene ADS, Razera APR, Maximiano TDO, Luiz AG, Dalben GDS, Gomide MR. Doubts of caregivers of children with cleft lip and palate on postoperative care after cheiloplasty and palatoplasty. Rev Esc Enferm USP 2014; 48:993-8. [DOI: 10.1590/s0080-623420140000700005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 09/01/2014] [Indexed: 11/22/2022] Open
Abstract
Objective To identify the main doubts of caregivers of children with cleft lip and palate on postoperative care after cheiloplasty and palatoplasty. Method Cross-sectional study carried out in a reference hospital, between September and November 2012. The sample was composed of 50 individuals divided in two groups, of which 25 caregivers of children submitted to cheiloplasty, and 25 of children submitted to palatoplasty. The doubts were identified by an interview applied during the preoperative nursing consultation and were then categorized by similarity. Descriptive statistics was used for analysis of the outcomes. Results Concerning cheiloplasty, the doubts were related to feeding (36%), hygiene and healing (24% each), pain and infection (8% each). With regard to palatoplasty, the doubts were related to feeding (48%), hygiene (24%), pain (16%), bleeding (8%) and infection (4%). Conclusion The study evidenced the concern of caregivers in relation to feeding and care of the postoperative wound.
Collapse
|
27
|
Martin V, Greatrex-White S. An evaluation of factors influencing feeding in babies with a cleft palate with and without a cleft lip. J Child Health Care 2014; 18:72-83. [PMID: 23439590 DOI: 10.1177/1367493512473853] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this article was to determine the impact of different bottles and teats for feeding babies with a cleft palate (with and without a cleft lip) on weight velocity, feeding behaviour, and maternal self-esteem. A mixed methods study incorporating the use of diaries to record feeding patterns of babies and levels of professional support received was used. Growth was assessed by converting weights into standard deviation scores and using the differences to express weight velocity over a six-week period. Visual analogue scales were used to assess mothers' perceptions of their children and themselves. The Edinburgh Postnatal Depression Score (EPDS) was used to identify maternal depression. The study demonstrated that the most significant effect on weight was determined by cleft type. Babies with isolated clefts of the hard and soft palate experienced greater feeding problems and suffered the biggest weight losses. This remained significant independently of the type of bottle/teat used. Poor weight gain was also associated with a mother's low perception of herself and her child, and her tendency towards depression. The study highlights the importance of the early assessment of babies' feeding skills and regular follow-up and support from trained and experienced nurse specialists.
Collapse
Affiliation(s)
- Vanessa Martin
- Trent Regional Cleft Lip and Palate Team, Nottingham University Hospitals, NHS Trust, UK (Retired)
| | | |
Collapse
|
28
|
Goyal M, Chopra R, Bansal K, Marwaha M. Role of obturators and other feeding interventions in patients with cleft lip and palate: a review. Eur Arch Paediatr Dent 2014; 15:1-9. [PMID: 24425528 DOI: 10.1007/s40368-013-0101-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 11/30/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Newborns with cleft palate have a distorted maxillary arch at birth. Depending upon the type of cleft, infants suffer from a variety of problems, many of which are related to feeding difficulties. Feeding these babies is an immediate concern because there is evidence of delayed growth of children with cleft lip and palate (CLCP) compared to normal infants. Many methods have been devised to overcome these problems, including the use of special bottles, nipples, and initial obturator therapy. REVIEW A Pub Med search was conducted using the following search terms: feeding interventions in cleft lip and palate, feeding plate/obturator in cleft palate. All the relevant articles were studied and the reference list of selected articles was also studied. Effects of different feeding interventions in infants with cleft palate with special emphasis on obturators, based on descriptive reports, expert opinions, and available data from clinical trials was reviewed. RESULTS The combination of search terms generated a list of 74 articles out of which 51 articles were excluded based on analyses of abstracts and full texts. Three additional publications were identified by the manual search. A total of 26 relevant articles were selected which included randomised controlled trials and descriptive studies on feeding interventions and obturators. CONCLUSION A single intervention may not fulfil all feeding requirements of infants with CLCP. Combined use of different feeding interventions such as palatal obturator, Haberman feeder, and breast milk pump and lactation education may successfully meet the feeding needs of both mother and child.
Collapse
Affiliation(s)
- M Goyal
- Department of Paedodontics and Preventive Dentistry, SGT Dental College, Hospital and Research Institute, Budhera, 122505, Gurgaon, India
| | | | | | | |
Collapse
|
29
|
Gil-da-Silva-Lopes VL, Monlleó IL. Risk factors and the prevention of oral clefts. Braz Oral Res 2014; 28 Spec No:1-5. [DOI: 10.1590/s1806-83242014.50000008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 12/10/2013] [Indexed: 11/22/2022] Open
|
30
|
de Vries IAC, Breugem CC, van der Heul AMB, Eijkemans MJC, Kon M, Mink van der Molen AB. Prevalence of feeding disorders in children with cleft palate only: a retrospective study. Clin Oral Investig 2013; 18:1507-15. [PMID: 24122307 DOI: 10.1007/s00784-013-1117-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 09/24/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study in children with cleft palate only (CPO) is to (1) explore the prevalence of feeding problems on a retrospective basis, (2) investigate rates of nasogastric (NG) feeding, (3) examine the prevalence of associated disorders and/or syndromes (AssD/S), (4) investigate if there are certain risk factors associated with feeding difficulties, NG feeding, and failure of breastfeeding, and (5) investigate the effect of palatoplasty on feeding difficulties. MATERIALS AND METHODS In total, 90 questionnaires were included in this study. The medical records were reviewed. RESULTS Feeding difficulties were reported in 67% (n = 60) of all cases. NG feeding was given in 32% (n = 28) of all children. Forty-nine children (54%) have associated malformations. There is no significant relation for gender, gestational age, and birth weight as risk factors for feeding difficulties, NG feeding, and failure of breastfeeding. The severity of the cleft is significantly related to the prevalence of AssD/S. After palatoplasty, feeding difficulties improved in 79% of the CPO children. CONCLUSIONS AND CLINICAL RELEVANCE First, our results clearly indicate that children with CPO are at high risk of developing feeding difficulties (67%); NG feeding is often necessary (32%). Second, our results also indicate that the more severe the cleft, the more likely the chance for AssD/S. Third, the severity of the cleft is significantly related to the prevalence of AssD/S. Fourth, there is no significant relation for gender, gestational age, and birth weight as risk factors for feeding difficulties, NG feeding, and failure of breastfeeding. Fifth, improvement of feeding difficulties after surgery supports the importance of the soft palate closure in relation to sucking patterns and feeding skills.
Collapse
Affiliation(s)
- I A C de Vries
- Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, PO Box 85500, 3508, GA, Utrecht, The Netherlands,
| | | | | | | | | | | |
Collapse
|