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European Archives of Paediatric Dentistry

, Volume 12, Issue 5, pp 250–255 | Cite as

An investigation into infant feeding in children born with a cleft lip and/or palate in the West of Scotland

  • K. F. M. BrittonEmail author
  • S. H. McDonald
  • R. R. Welbury
Article

Abstract

AIM: To investigate feeding practices in infants born with a cleft lip and/or palate (CLP) in the West of Scotland and the challenges that the parents of these children experienced especially in the first hours and months after birth. METHODS: A questionnaire involving a ‘face-to-face’ interview was completed with parents of cleft children under the age of 6 years with a cleft lip and/or palate attending the Oral Orthopaedic Prevention Clinic (OOPC). RESULTS: 90 questionnaires were completed and analysed. The incidence of breastfeeding in this study at birth was 54%. In comparison, the incidence of breastfeeding in Scotland nationally was 63% in the year 2000 and 70% in 2005 indicating a lower uptake of breastfeeding for this CLP population. Cleft type had a significant impact on whether the infant was breastfed (p<0.05), those with a cleft lip being more likely to be breastfed. Twenty-nine percent of cleft infants required the use of a naso-gastric tube (NGT) to assist feeding either in hospital during the days following birth or later when there were concerns about the infant’s weight. Of these all but one had a CP+/−CL, (p<0.001); 26% of parents reported that their infant had used a pre-surgical appliance; 70% rated the appliance highly in terms of aiding feeding. The help and support given by the cleft team, especially Specialist Cleft Nurses (SCNs), was rated as positive in over 95% of cases but was less positive for the non-cleft health care professionals. Parents found it difficult to find the right feeding method for their baby until they received input from the SCNs and only a minority of parents managed to establish a regular feeding pattern. CONCLUSIONS: This study recommends the employment of more SCNs and an improvement of the knowledge of non-cleft health care professionals.

Key words

Children bdfeeding bdcleft lip/palate 

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References

  1. Aniansson G, Svensson H, Becker M, Ingvarsson L. Otitis media and feeding with breast milk of children with cleft palate. Scand J Plastic Reconst Surg and Hand Surg 2002; 36:9–15.CrossRefGoogle Scholar
  2. Beaumont D. A study into weight gain in infants with cleft lip/palate. Paediatr Nurs. 2008; 20:20–23.PubMedGoogle Scholar
  3. Bian Z, Du M, Bedi R et al. Caries experience and oral health behaviour in Chinese children with cleft lip and/or palate. Pediatr Dent 2001; 23:431–434.PubMedGoogle Scholar
  4. Biancuzzo, M. Clinical focus on clefts. Yes! Infants with clefts can breastfeed. AWHONN Lifeline 1998; 2:45–49.CrossRefGoogle Scholar
  5. Bokhout B, Hofman FX, van Limbeek J, Kramer GJ, Prahl-Andersen B. Incidence of dental caries in the primary dentition in children with a cleft lip and/or palate. Caries Res 1997; 31:8–12.PubMedCrossRefGoogle Scholar
  6. Britton KFM, Welbury RR. Dental caries prevalence in children with cleft lip/palate aged between 6 months and 6 years in the West of Scotland. Eur Arch Paediatr Dent 2010; 11:236–241.PubMedGoogle Scholar
  7. Carstairs V, Morris R. 1991,Deprivation and Health in Scotland. Aberdeen University Press, Aberdeen.Google Scholar
  8. Cash C, Set P, Coleman N. The accuracy of antenatal ultrasound in the detection of facial clefts in a low-risk screening population. Ultrasound in Obstetrics Gynecology 2001; 18: 432–436.PubMedCrossRefGoogle Scholar
  9. Chapple JR, Nunn JH. The oral health of children with clefts of the lip, palate, or both. Cleft Palate Craniofac J 2001; 38:525–528.PubMedCrossRefGoogle Scholar
  10. CLAPA Report 2007. Regionalisation of cleft lip and palate services: has it worked? A report on users’ perspectives of cleft care. http://www.clapa.com/documents/Full%20report%20final.pdf
  11. Clark JD, Mossey PA, Sharp L, Little J. Socioeconomic status and orofacial clefts in Scotland, 1989 to 1998. Cleft Palate Craniofac J 2003; 40:481–485.PubMedCrossRefGoogle Scholar
  12. Clarren SK, Anderson B, Wolf LS. Feeding infants with cleft lip, cleft palate, or cleft lip and palate. Cleft Palate J 1987; 24:224–249.Google Scholar
  13. CLEFTSiS, The National Managed Clinical Network for Cleft Services in Scotland. Annual Report 2006:www.cleftsis.scot.nhs.uk
  14. CLEFTSiS, The National Managed Clinical Network for Cleft Services in Scotland. Annual Report 2008:www.cleftsis.scot.nhs.uk
  15. CLEFTSiS, The National Managed Clinical Network for Cleft Services in Scotland. Annual Report 2009:www.cleftsis.scot.nhs.uk
  16. Clementi M, Tenconi R, Bianchi F, Stoll C. Evaluation of prenatal diagnosis of cleft lip with or without cleft palate and cleft palate by ultrasound: experience from 20 European registries. EUROSCAN study group. Prenatal Diagnosis 2000; 20:870–875.PubMedCrossRefGoogle Scholar
  17. Crossman, K. Breastfeeding a baby with a cleft palate: a case report. Journal of human lactation: Official journal of International Lactation Consultant Association 1998; 14:47–50.CrossRefGoogle Scholar
  18. CSAG, The Clinical Standards Advisory Group (CSAG) Cleft Lip and Palate Study. Br J Orth 1998; 25:21–30.CrossRefGoogle Scholar
  19. Dahllof G, Ussisoo-Joandi R, Ideberg M, Modeer T. Caries, gingivitis, and dental abnormalities in preschool children with cleft lip and/or palate. Cleft Palate J 1989; 26:233–237.PubMedGoogle Scholar
  20. Danner SC. Breastfeeding the infant with a cleft defect. NAACOGS Clinical Issues in Perinatal and Women’s Health and Nursing 1992; 3:634–639.Google Scholar
  21. da Silva Dalben G, Costa B, Gomide M, Teixeira Neves L. Breast-feeding and sugar intake in babies with cleft lip and palate. Cleft Palate Craniofac J 2003; 40:84–87.CrossRefGoogle Scholar
  22. Hart C, Bain J. Child care in general practice. London: Churchill Livingstone 1989.Google Scholar
  23. Infant Feeding Practices 2000 UK Department of Health:www.dh.gov.uk
  24. Infant Feeding Survey 2005 UK Health and Social care:www.ic.nhs.uk/pubs/ifs2005
  25. Ishida R, Yasufuku Y, Miyamoto A, Ooshima T, Sobue S. Clinical survey of caries incidence in children with cleft lip and palate. Shoni Shikagaku Zasshi 1989; 27:716–724 (Japanese).PubMedGoogle Scholar
  26. Johnsen DC, Dixon M. Dental caries of primary incisors in children with cleft lip and palate. Cleft Palate J 1984; 21:104–109.PubMedGoogle Scholar
  27. Kirchberg A, Treide A, Hemprich A. Investigation of caries prevalence in children with cleft lip, alveolus, and palate. J Cranio-Maxillo-Fac Surg 2004; 32:216–219.CrossRefGoogle Scholar
  28. Konst E, Prahl C, Weersink-Braks H. Cost-Effectiveness of Infant Orthopedic Treatment Regarding Speech in Patients With Complete Unilateral Cleft Lip and Palate: A Randomized Three-Center Trial in the Netherlands (Dutchcleft) Cleft Palate Craniofac J 2004; 41:71–77.PubMedCrossRefGoogle Scholar
  29. Lawrence RA. A review of the medical benefits and contraindications to breastfeeding in the United States. Maternal and Child Health Technical Information Bulletin, Arlington, VA: National Centre for Education in Maternal and Child Health 1997.Google Scholar
  30. Lin YT, Tsai CL. Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan. Cleft Palate Craniofac J 1999; 36:522–526.PubMedCrossRefGoogle Scholar
  31. Martin V, Rose DH. Prenatal diagnosis of cleft lip. In Cleft Care: A practical guide for health professionals on cleft lip and/or palate. Ch 4. ed. Martin V, Bannister P. Wiltshire: APS Publishing 2004.Google Scholar
  32. Maseri AG, Sell D, Habel A et al. The nature of feeding in infants with unrepaired cleft lip and/or palate compared with healthy non-cleft infants. Cleft Palate Craniofac J 2007; 44:321–328.CrossRefGoogle Scholar
  33. McLoone P. Carstairs Scores for Scottish Postcode Sectors from the 1991 & 2001 Censuses. Public Health Research Unit; University of Glasgow 2004.Google Scholar
  34. Mossey PA, Little J. Epidemiology of oral clefts: An international perspective, in Wyszynski D.F. (ed). Cleft Lip and Palate. From Origin to Treatment. New York: Oxford University Press, 2002, pp.127–144.Google Scholar
  35. Reid J, Kilpatrick N, Reilly S. A prospective, longitudinal study of feeding skills in a cohort of babies with cleft conditions. Cleft Palate Craniofac J 2006; 43:702–709.PubMedCrossRefGoogle Scholar
  36. Reid J, Reilly S, Kilpatrick N. Sucking performance of babies with cleft conditions. Cleft Palate Craniofac J 2007; 44:312–320.PubMedCrossRefGoogle Scholar
  37. SNAP, 1994. ai]Pitts N, Binnie V, Gerrish A, Mackenzie NM, Watkins TR. Scottish Needs Assessment Programme — Dental Caries in Children. Scottish Forum for Public Health Medicine. Glasgow.Google Scholar
  38. SNAP, 1998. Pitts N, Binnie V, Gerrish A, Stevenson J. Scottish Needs Assessment Programme. Dental Caries in Children (update). Scottish Forum for Public Health Medicine. Glasgow.Google Scholar
  39. Sohan K, Freer M, Mercer N, Soothill P, Kyle P. Prenatal detection of facial clefts. Fetal Diagnosis and Therapy 2001; 16:196–199.PubMedCrossRefGoogle Scholar
  40. Stoll C, Dott B, Alembik Y, Roth M. Evaluation of prenatal diagnosis of cleft lip/palate by foetal ultrasonographic examination. Ann Genetics 2000; 43:11–14.CrossRefGoogle Scholar
  41. Suresh S, Vijayalakshmi R, Indrani S, Devaki G, Bhavani K. The premaxillary triangle: clue to the diagnosis of cleft lip and palate. J Ultrasound Medicine 2006; 25:237–242.Google Scholar
  42. Trenouth MJ, Campbell AN. Questionnaires for evaluation of feeding methods of cleft lip and palate neonates Int J Paed Dent 1996; 6:241–244CrossRefGoogle Scholar
  43. Williams A, Bearn D, Mildinhall S. Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 2: Dentofacial Outcomes and Patient Satisfaction. Cleft Palate Craniofac J 2001; 38:24–29.PubMedCrossRefGoogle Scholar
  44. Wilton JM. Cleft palates and breastfeeding. AWHONN Lifelines 1998; 2:11.PubMedCrossRefGoogle Scholar
  45. Womersley J, Stone DH. Epidemiology of facial clefts. Arch Dis Child 1987; 62:717–720.PubMedCrossRefGoogle Scholar

Copyright information

© European Archives of Paediatric Dentistry 2011

Authors and Affiliations

  • K. F. M. Britton
    • 1
    Email author
  • S. H. McDonald
    • 1
  • R. R. Welbury
    • 1
  1. 1.Department of Paediatric DentistryGlasgow Dental Hospital and SchoolGlasgowScotland

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