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Feeding Protocol in Cleft Palate Patients

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Surgical Atlas of Cleft Palate and Palatal Fistulae

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Abstract

Feeding difficulty is usually the most serious and urgent concern after birth in children with cleft lip and palate. The cleft lip makes it difficult to make a seal around the nipple. The cleft palate results in an inability to generate negative pressure for sucking milk. Feeding assistance and education are needed soon after birth, by a feeding specialist or a nurse with expertise in feeding babies with clefts. Special feeding techniques and specialty feeding equipment are utilized. Breast milk is the best form of nutrition for an infant. While babies with an isolated cleft lip are able to breast feed via technique modifications, the vast majority of babies with cleft palate are unable to feed at the breast. Breast milk can be pumped by the mother and fed to the infant via bottle or cup. Various specialty feeding systems have been developed. Weight gain is used as a measure of adequate food intake. Infants should be regularly evaluated by a cleft feeding specialist to ensure optimum feeding until after cleft palate repair when normal feeding mechanism should be restored. Caregiver education is critical for success of any infant feeding strategy.

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References

  • Baby bottles and Bisphenol A (BPA). Retrieved 3 March, 2020, from https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Baby-Bottles-And-Bisphenol-A-BPA.aspx

  • Baylis AL, Pearson GD, Hall C, Madhoun LL, Cummings C, Neal N, Smith A, Eastman K, Stocker C, Kirschner RE (2018) A quality improvement initiative to improve feeding and growth of infants with cleft lip and/or palate. Cleft Palate Craniofac J 55(9):1218–1224

    Article  Google Scholar 

  • Boyce JO, Reilly S, Skeat J, Cahir P, M. Academy of Breastfeeding (2019) ABM clinical protocol #17: guidelines for breastfeeding infants with cleft lip, cleft palate, or cleft lip and palate-revised 2019. Breastfeed Med 14(7):437–444

    Article  Google Scholar 

  • Chow I, Purnell CA, Hanwright PJ, Gosain AK (2016) Evaluating the rule of 10s in cleft lip repair: do data support dogma? Plast Reconstr Surg 138(3):670–679

    Article  CAS  Google Scholar 

  • Cleft lip/palate nurser, ready-to-fill. Retrieved 3 March, 2020, from https://www.enfamil.com/products/accessories/

  • Cleft palate bottle & teats. Retrieved 3 March, 2020, from https://www.pigeon.com.pk/cleft-palate

  • Cooper-Brown L, Copeland S, Dailey S, Downey D, Petersen MC, Stimson C, Van Dyke DC (2008) Feeding and swallowing dysfunction in genetic syndromes. Dev Disabil Res Rev 14(2):147–157

    Article  Google Scholar 

  • Corbett SS, Drewett RF (2004) To what extent is failure to thrive in infancy associated with poorer cognitive development? A review and meta-analysis. J Child Psychol Psychiatry 45(3):641–654

    Article  CAS  Google Scholar 

  • Cu SR, Sidman JD (2011) Rates and risks of gastrostomy tubes in infants with cleft palate. Arch Otolaryngol Head Neck Surg 137(3):275–281

    Article  Google Scholar 

  • DiTomasso D, Cloud M (2019) Systematic review of expected weight changes after birth for full-term, breastfed newborns. J Obstet Gynecol Neonatal Nurs 48(6):593–603

    Article  Google Scholar 

  • Division of Nutrition, P. A., and Obesity, National Center for Chronic Disease Prevention and Health Promotion (2020) Proper storage and preparation of breast milk. January 22. Retrieved 3 March, 2020, from https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

  • Dr. Brown’s® specialty feeding system. Retrieved 3 March, 2020, from https://www.drbrownsbaby.com/medical/products/specialty-feeding/

  • Duarte GA, Ramos RB, Cardoso MC (2016) Feeding methods for children with cleft lip and/or palate: a systematic review. Braz J Otorhinolaryngol 82(5):602–609

    Article  Google Scholar 

  • Duffy L (2012) Weight changes and growth patterns following palatoplasty. Plast Surg Nurs 32(3):127–128

    Article  Google Scholar 

  • Eglash A, Simon L, M. Academy of Breastfeeding (2017) ABM clinical protocol #8: human milk storage information for home use for full-term infants, revised 2017. Breastfeed Med 12(7):390–395

    Article  Google Scholar 

  • Genecov DG, Barcelo CR, Steinberg D, Trone T, Sperry E (2009) Clinical experience with the application of distraction osteogenesis for airway obstruction. J Craniofac Surg 20(Suppl 2):1817–1821

    Article  Google Scholar 

  • Goyal M, Chopra R, Bansal K, Marwaha M (2014) Role of obturators and other feeding interventions in patients with cleft lip and palate: a review. Eur Arch Paediatr Dent 15(1):1–9

    Article  CAS  Google Scholar 

  • Habicht JP, W. H. O. E. Consultation (2004) Expert consultation on the optimal duration of exclusive breastfeeding: the process, recommendations, and challenges for the future. Adv Exp Med Biol 554:79–87

    Article  Google Scholar 

  • Hsieh ST, Woo AS (2019) Pierre Robin sequence. Clin Plast Surg 46(2):249–259

    Article  Google Scholar 

  • Katge FDS, Shetty A, Shetty S (2014) Feeding intervention in cleft lip and palate patients: a review. Int J Dent Med Res 1(4):143–147

    Google Scholar 

  • Kaye A, Thaete K, Snell A, Chesser C, Goldak C, Huff H (2017) Initial nutritional assessment of infants with cleft lip and/or palate: interventions and return to birth weight. Cleft Palate Craniofac J 54(2):127–136

    Article  Google Scholar 

  • Kramer MS, Kakuma R (2012) Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev 8:CD003517

    Google Scholar 

  • Lactation Education Accreditation and Approval Review Committee, Campbell SH, Lauwers J, Mannel R, Spencer B (2019) Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning, Burlington

    Google Scholar 

  • Masarei AG, Sell D, Habel A, Mars M, Sommerlad BC, Wade A (2007) The nature of feeding in infants with unrepaired cleft lip and/or palate compared with healthy noncleft infants. Cleft Palate Craniofac J 44(3):321–328

    Article  CAS  Google Scholar 

  • Masarei AG, Wade A, Mars M, Sommerlad BC, Sell D (2007) A randomized control trial investigating the effect of presurgical orthopedics on feeding in infants with cleft lip and/or palate. Cleft Palate Craniofac J 44(2):182–193

    Article  CAS  Google Scholar 

  • Matsuo K, Palmer JB (2008) Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am 19(4):691–707, vii

    Article  Google Scholar 

  • McFadden A, Gavine A, Renfrew MJ, Wade A, Buchanan P, Taylor JL, Veitch E, Rennie AM, Crowther SA, Neiman S, MacGillivray S (2017) Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2:CD001141

    PubMed  Google Scholar 

  • McKinney CM, Glass RP, Coffey P, Rue T, Vaughn MG, Cunningham M (2016) Feeding neonates by cup: a systematic review of the literature. Matern Child Health J 20(8):1620–1633

    Article  Google Scholar 

  • McKinney CM, Balakrishnan U, Ninan B, Glass R, Cunningham M, Murthy J (2020) A comparative study of two infant feeding tools: the nifty cup and the paladai. Indian J Pediatr

    Google Scholar 

  • Miller CK (2011) Feeding issues and interventions in infants and children with clefts and craniofacial syndromes. Semin Speech Lang 32(2):115–126

    Article  Google Scholar 

  • Monasterio FO, Molina F, Berlanga F, Lopez ME, Ahumada H, Takenaga RH, Ysunza A (2004) Swallowing disorders in Pierre Robin sequence: its correction by distraction. J Craniofac Surg 15(6):934–941

    Article  Google Scholar 

  • Nutrition Supervision. Bright futures: nutrition. Retrieved 3 March, 2020, from https://brightfutures.aap.org/Bright%20Futures%20Documents/BFNutrition3rdEditionSupervision.pdf

  • Ongkasuwan J (2018) Pediatric dysphagia: challenges and controversies. Springer Berlin Heidelberg, New York

    Book  Google Scholar 

  • Pandya AN, Boorman JG (2001) Failure to thrive in babies with cleft lip and palate. Br J Plast Surg 54(6):471–475

    Article  CAS  Google Scholar 

  • Paul IM, Schaefer EW, Miller JR, Kuzniewicz MW, Li SX, Walsh EM, Flaherman VJ (2016) Weight change nomograms for the first month after birth. Pediatrics 138(6)

    Google Scholar 

  • Peters RT, Balduyck B, Nour S (2010) Gastrostomy complications in infants and children: a comparative study. Pediatr Surg Int 26(7):707–709

    Article  Google Scholar 

  • Prahl C, Kuijpers-Jagtman AM, Van ’t Hof MA, Prahl-Andersen B (2005) Infant orthopedics in UCLP: effect on feeding, weight, and length: a randomized clinical trial (Dutchcleft). Cleft Palate Craniofac J 42(2):171–177

    Article  Google Scholar 

  • Reid J (2004) A review of feeding interventions for infants with cleft palate. Cleft Palate Craniofac J 41(3):268–278

    Article  Google Scholar 

  • Reid J, Kilpatrick N, Reilly S (2006) A prospective, longitudinal study of feeding skills in a cohort of babies with cleft conditions. Cleft Palate Craniofac J 43(6):702–709

    Article  Google Scholar 

  • Sakalidis VS, Geddes DT (2016) Suck-swallow-breathe dynamics in breastfed infants. J Hum Lact 32(2):201–211; quiz 393–205

    Article  Google Scholar 

  • Section on, B. (2012) Breastfeeding and the use of human milk. Pediatrics 129(3):e827–e841

    Article  Google Scholar 

  • Shaw WC, Bannister RP, Roberts CT (1999) Assisted feeding is more reliable for infants with clefts – a randomized trial. Cleft Palate Craniofac J 36(3):262–268

    Article  CAS  Google Scholar 

  • Sippy cups for cleft affected children. Retrieved 3 March, 2020, from http://www.cleftopedia.com/special-feeders/sippy-cups/

  • SpecialNeeds® Feeder. Retrieved 3 March, 2020, from http://www.medelabreastfeedingus.com/products/576/specialneeds-feeder

  • Staff, S. (2010) Cleft lip and cleft palate: spoon feeding and cup drinking. April 13. Retrieved 3 March, 2020, from https://www.aboutkidshealth.ca/article?contentid=968&language=english

  • Wagner CL, Greer FR, B. American Academy of Pediatrics Section on and N. American Academy of Pediatrics Committee on (2008) Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 122(5):1142–1152

    Article  Google Scholar 

  • Wolf LS, Glass RP (1992) Feeding and swallowing disorders in infancy : assessment and management. Therapy Skill Builders, Tucson

    Google Scholar 

  • Woods SM, Garfinkle JS, Covell DA Jr, Wang M, Busch LS, Doyle LM (2019) Early weight gain in infants with cleft lip and palate treated with and without nasoalveolar molding: a retrospective study. Cleft Palate Craniofac J 56(7):902–907

    Article  Google Scholar 

  • Zhang RS, Hoppe IC, Taylor JA, Bartlett SP (2018) Surgical management and outcomes of Pierre Robin sequence: a comparison of mandibular distraction osteogenesis and tongue-lip adhesion. Plast Reconstr Surg 142(2):480–509

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Plastic Surgery, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, New York, NY, USA

    Farooq Shahzad

  2. Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Paymon Sanati-Mehrizy

Authors
  1. Farooq Shahzad
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  2. Paymon Sanati-Mehrizy
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Correspondence to Farooq Shahzad .

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Editors and Affiliations

  1. Plastic Surgery, Services Institute of Medical Sciences, Lahore, Pakistan

    Ghulam Qadir Fayyaz

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Shahzad, F., Sanati-Mehrizy, P. (2022). Feeding Protocol in Cleft Palate Patients. In: Fayyaz, G.Q. (eds) Surgical Atlas of Cleft Palate and Palatal Fistulae. Springer, Singapore. https://doi.org/10.1007/978-981-15-3889-6_22-1

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  • DOI: https://doi.org/10.1007/978-981-15-3889-6_22-1

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-3889-6

  • Online ISBN: 978-981-15-3889-6

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