Feeding difficulties in infants with unrepaired cleft lip and palate and HIV-exposure

Abstract

BackgroundThere is limited description of the feeding characteristics of infants with unrepaired cleft lip and palate, exposed to HIV, but not necessarily infected.ObjectiveTo compare the feeding characteristics of infants with unrepaired cleft lip and palate and HIV-exposure, to infants with unrepaired cleft lip and palate only.MethodA two-group comparative design with a validated measure, the Neonatal Feeding Assessment Scale was used. The effectiveness of oral feeding skills were included as objective measure. Twelve participants with unrepaired cleft lip and palate and HIV-exposure and 13 with unrepaired cleft lip and palate were matched according to cleft type and use of feeding obturator. There were no differences between the groups for mean age, birth weight and gestation. Participants were between two and 89 days old, bottle fed, and had no syndrome/co-occurring disorder.ResultsNine (75%) participants in the research group and only two (15.38%) in the control grouppresented with the likelihood of oropharyngeal dysphagia. Apart from feeding difficulties as a result of structural impairment, the research group showed symptoms of neurological involvement.ConclusionThe research group presented with distinctive symptoms of oropharyngeal dysphagia. More studies using different measuring tools are required to strengthen the evidence.

The characteristics and perioperative outcomes of children with orofacial clefts managed at an academic hospital in Johannesburg, South Africa

“…The regimens implicated were Tenofovir/Lamivudine/Efavirenz regimen and Zidovudine/Lamivudine/Nevirapine [ 25 ]. Another study, concluded that children exposed to HIV in utero who had orofacial clefts, suffered from oropharyngeal dysphagia, as opposed to non-exposed children, concluding that HIV had a neurological impact on exposed children [ 26 ]. Other environmental factors that have been described are poor maternal nutrition, vitamin and mineral deficiencies [ 2 , 10 ].…”

Cleft Lip and Palate Nutritional Assessment and Feeding challenges

“…However, the remaining 13.3% presented minor issues such as lake of generating proper lip seal, milk regurgitation, postpartum fatigue which is reliable with other studies. Several studies reported the benefits of using syringe in compassion to spoon in increasing the volume intake and speeding the feeding time to reach the normal 29,30,31 . Feeding bottles had proven efficiency in providing infants with the proper quantity they needed for better weight gain.…”

Breastfeeding Outcomes and Associated Risks in HIV-Infected and HIV-Exposed Infants: A Systematic Review

“…19 As health care professionals involved in breastfeeding, speech-language pathologists (SLPs) support the BFHI by advocating for breastfeeding when possible and managing EBF difficulties, especially for families from low-income settings who experience greater barriers to successful breastfeeding. 20,21 One South African study identified swallowing and feeding difficulties, or oropharyngeal dysphagia, in a group of HE versus HU infants (>3 months) with cleft lip and palate. 21 Other studies have, however, reported no difference in early swallowing and feeding of neonates with HE compared to HU peers.…”

“…20,21 One South African study identified swallowing and feeding difficulties, or oropharyngeal dysphagia, in a group of HE versus HU infants (>3 months) with cleft lip and palate. 21 Other studies have, however, reported no difference in early swallowing and feeding of neonates with HE compared to HU peers. 14,22 Further research is required to develop a profile of breastfeeding outcomes of HE infants.…”