The Nature of Feeding in Infants with Unrepaired Cleft Lip and/or Palate Compared with Healthy Noncleft Infants

Abstract

This study demonstrated that the sucking patterns of infants with nonsyndromic complete unilateral cleft lip and palate or a cleft of the soft and at least two thirds of the hard palate differ from those of their noncleft peers.

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

“…13 For this reason, babies with CL are more likely to breastfeed than those with CP and CLP. 14 Some babies with small clefts of the soft palate generate suction, 15 but others with larger clefts of the soft and/or hard palate may not generate suction. 15,16 Newborns and premature babies generate lower suction pressures compared with older babies.…”

“…14 Some babies with small clefts of the soft palate generate suction, 15 but others with larger clefts of the soft and/or hard palate may not generate suction. 15,16 Newborns and premature babies generate lower suction pressures compared with older babies. 13,17,18 Babies with CP or CLP have difficulty creating suction 19 because the oral cavity cannot be adequately separated from the nasal cavity during feeding.…”

“…There is moderate evidence to suggest that infants with CL are able to generate suction 19 (III), and descriptive reports suggest that these infants are often able to breastfeed successfully. 24 (III) There is moderate evidence that infants with CP or CLP have difficulty generating suction 15 (I) and have inefficient sucking patterns 16 (I) compared with normal infants. The success rates for breastfeeding infants with CP or CLP are observed to be lower than for infants with CL or no cleft.…”

“…There was moderate (II-2) evidence that babies with CL create suction during feeding. 15,19 Descriptive (III) studies have demonstrated successful breastfeeding at rates approaching the normal population. 23 Expert opinion (III) suggests that infants with CL may find breastfeeding relatively easier than bottle feeding because the breast tissue molds to the cleft and occludes the defect more successfully than an artificial nipple.…”

“…There was moderate (II-2) evidence that infants with CP do not create suction when bottle feeding. 15,19 Although infants with clefts of the soft palate may be able to create suction, this is not usually the case. 13,15 Descriptive studies indicate that breastfeeding success for infants with CP is much lower than for infants with CL.…”