Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate

Cleft Palate Only: Current Concepts

“…Aerophagia is a problem in these infants with CPO and breastfeeding may take longer to allow burping. Sometimes, a nasogastric tube or surgical gastric tube may allow child to feed from a bottle (91). CPO obturator is manufactured to allow separation of the nasal and oropharynx.…”

Health professional communication and the diagnosis and care of infants born with cleft lip and palate in the U.K.

“…The role of the CNS is to provide support to parents following diagnosis and after the child's birth, helping them to understand prognostic and treatment implications as well as more specific issues such as feeding (Bannister, 2008;Beaumont, 2012;Bessell et al, 2010).…”

“…Unfortunately this is not always provided and parents of children born with a cleft have, historically, expressed dissatisfaction with the way that breastfeeding support and information is provided, often because staff lack knowledge and expertise (Nelson et While the CNS are trained to assess the infant's oral skills after birth and provide advice about appropriate and effective feeding methods, they may not always be able to attend in the immediate period after the birth (Beaumont, 2012). In such situations, mothers have reported receiving little or no support, being given inaccurate advice and being discouraged from even trying to breastfeed by the non-specialist health care professionals who are present (Bessell et al, 2010). This is likely to result in added stress, confusion, uncertainty and anxiety for parents and health professionals at a time that is already difficult (Lindberg & Berglund, 2011) …”

ABM Clinical Protocol #17: Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate, Revised 2013

“…There are several studies that have yielded strong evidence to inform this area (I, II-2). There is moderate to strong evidence (I, II-2) that it is safe to commence/recommence breastfeeding immediately following CL repair, 41,42 and there is moderate evidence (II-2) for initiating breastfeeding 1 day after CP repair. 41 There is strong evidence (I) that breastfeeding immediately following surgery is more effective for weight gain, with lower hospital costs, than spoon feeding.…”