Breast Milk Feeding Practices and Barriers and Supports Experienced by Mother–Infant Dyads With Cleft Lip and/or Palate

2019 ◽  
Vol 57 (4) ◽  
pp. 477-486 ◽  
Author(s):  
Lauren L. Madhoun ◽  
Canice E. Crerand ◽  
Sarah Keim ◽  
Adriane L. Baylis
Keyword(s):  
Breast Milk ◽  
Support Groups ◽  
Online Survey ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Feeding Practices ◽  
The United States ◽  
Lower Percentage ◽  
Cross Sectional ◽  
Milk Feeding

Objective: To examine trends in breast milk provision and to characterize the breast milk feeding practices experienced by mother–infant dyads with cleft lip and/or palate (CL/P) in a large US sample. Design: Cross-sectional study. Methods: An online survey was distributed through cleft-related social media sites in the United States and in a single cleft lip and palate clinic. Statistical analyses included Kruskal-Wallis H tests and post hoc Mann-Whitney tests to examine group differences based on cleft type and prenatal versus postnatal cleft diagnosis. Linear regression was used to estimate associations between obtained variables. Participants: One hundred fifty biological mothers of infants (8-14 months of age) with CL/P (15% cleft lip, 29% cleft palate, 56% cleft lip and palate). Results: Forty-six percent of mothers of infants with CL/P provided breast milk to their infant for at least 6 months. Five percent of infants ever fed at breast, and 43% received pumped breast milk via bottle. The most commonly reported supports included lactation consultants, nurses, feeding therapists, and online support groups. Feeding therapy was received by 48% of infants. Conclusions: A lower percentage of mothers of infants with CL/P reported providing breast milk compared to national estimates of the general population of infants without clefting. Results suggested there are multiple barriers, as well as numerous medical and psychosocial supports that facilitated breast milk feeding success. Implications for care are discussed.

Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
Author(s):  
Lisa H. V. Smedegaard ◽  
Dorthe R. N. Marxen ◽  
Jette H. V. Moes ◽  
Eva N. Glassou ◽  
Cand Scientsan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Health Visitors ◽  
Facial Clefts ◽  
Growth References ◽  
First Year Of Life ◽  
Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

Breast Milk Feeding Rates in Patients with Cleft Lip and Palate at a North American Craniofacial Center

2017 ◽  
Vol 54 (3) ◽  
pp. 334-337 ◽  
Author(s):  
Michael Alperovich ◽  
Jordan D. Frey ◽  
Pradip R. Shetye ◽  
Barry H. Grayson ◽  
Raj M. Vyas
Keyword(s):  
Breast Milk ◽  
North American ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Feeding Habits ◽  
Feeding Rates ◽  
Initiation Rate ◽  
Oral Clefts ◽  
The North ◽  
Milk Feeding

Objective Our study goal was to evaluate the rates of breast milk feeding among patients with oral clefts at a large North American Craniofacial Center. Methods Parents of patients with oral clefts born from 2000 to 2012 and treated at our center were interviewed regarding cleft diagnosis, counseling received for feeding, and feeding habits. Results Data were obtained from parents of 110 patients with oral clefts. Eighty-four percent of parents received counseling for feeding a child with a cleft. Sixty-seven percent of patients received breast milk for some period of time with a mean duration of 5.3 months (range 0.25 to 18 months). When used, breast milk constituted the majority of the diet with a mean percentage of 75%. Breast milk feeding rates increased successively over the 13-year study period. The most common method of providing breast milk was the Haberman feeder at 75% with other specialty cleft bottles composing an additional 11%. Parents who received counseling were more likely to give breast milk to their infant ( P = .02). Duration of NasoAlveolar Molding prior to cleft lip repair did not affect breast milk feeding length ( P = .72). Relative to patients with cleft lip and palate, patients with isolated cleft lip had a breast milk feeding odds ratio of 1.71. Conclusion We present breast milk feeding in the North American cleft population. Although still lower than the noncleft population, breast milk feeding with regards to initiation rate, length of time, and proportion of total diet is significantly higher than previously reported.

Feeding practices of children aged 0 to 24 months with clefts attending a specialized hospital in Uganda

2019 ◽  
Author(s):  
Maureen Nabatanzi ◽  
Gloria Kimuli Seruwagi ◽  
Florence Basiimwa Tushemerirwe ◽  
David Lubogo
Keyword(s):  
Child Nutrition ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
World Health ◽  
Nutrition Status ◽  
Cross Sectional ◽  
Oral Clefts ◽  
Feeding Difficulties

Abstract Background: Appropriate feeding practices are vital for child nutrition. Despite a low incidence of 0.73 in 1000, Ugandan children with oral clefts face feeding difficulties that affect their feeding practices, nutrition status and health.Objective: To determine the feeding practices, techniques and maternal feeding knowledge among children with oral clefts attending Comprehensive Rehabilitative Services of Uganda (CoRSU) HospitalMethods: This survey was part of a cross-sectional study on feeding practices, mothers’ experiences and support. We consecutively sampled 32 mothers of children with oral clefts aged 0 to 24 months attending CoRSU hospital between April and May, 2018. A structured questionnaire collected data on feeding practices, techniques and maternal feeding knowledge. Descriptive statistics were analyzed using SPSS software.Results: Most children (56%) had cleft lip and palate. Early initiation of breastfeeding was 44% and exclusive breastfeeding was 35%. None continued breastfeeding beyond 12 months. Timely introduction of complementary foods was 75%. 58% met the minimum dietary diversity score, 83% met the minimum meal frequency and 33% received a minimum acceptable diet. 75% of the mothers used bottles, cups and spoons in feeding their children. Majority preferred the specialized soft bottle (50%). 28% of the mothers were knowledgeable on the World Health Organization recommended feeding practices. Conclusions: This cleft group had suboptimal feeding practices since none of the children breastfed beyond 12 months and only one third received an acceptable diet. Varied feeding techniques were employed to improve feeding; majority preferred the specialized soft bottle. Most mothers had inadequate knowledge on feeding. There is need to improve the feeding guidance given to mothers of children with oral clefts. Our findings can guide the design of appropriate feeding interventions for this group.

scholarly journals Atypical Outcomes of Nasal and Lip Appearance After Unilateral Cleft Lip Repair: Judgment by Professionals, Patients, and Laypeople

2021 ◽  
pp. 105566562098280
Author(s):  
Robin A. Tan ◽  
Frans J. Mulder ◽  
Roderic M. F. Schwirtz ◽  
David G. M. Mosmuller ◽  
Henrica C. W. De Vet ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Online Survey ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Old Patients ◽  
Rank Score ◽  
Cleft Lip Repair ◽  
Typical Appearance ◽  
Unilateral Cleft Lip Repair ◽  
Insight Into

Objective: To gain more insight into the assessment of “atypical” nasal and lip appearance outcomes compared to “typical” appearance outcomes after unilateral cleft lip and palate (UCLP) repair, when judged by professionals, patients with repaired UCLP, and laypeople. Design: An online survey containing 3 series of photographs with various degrees of “typical” and “atypical” nasal and lip appearance outcomes after UCLP repair was sent to 30 professionals, 30 patients with repaired UCLP, and 50 laypeople in 2 countries. Participants were instructed to rank the photographs from excellent to poor based on overall appearance. Mean rank positions of photographs were analyzed and differences in mean rank score between “typical” and “atypical” results were assessed using a T-test. Agreement of ranking between the 3 groups was assessed with an analysis of variance analysis. Setting: Amsterdam UMC, location VUmc, Netherlands and Boston Children’s Hospital, Boston, USA. Patients: Photographs of 6- to 18-year-old patients with repaired UCLP. Results: “Atypical” appearance outcomes were ranked significantly less favorably (small nostril: P = 0.00; low vermillion border: P = 0.02; whistling deformity: P = 0.00) compared to “typical” outcomes. Difference between professionals, patients and laypeople in rank positioning the photographs was not statistically significant ( P = 0.89). Conclusions: Noses with a smaller nostril and lips containing a whistling deformity were perceived as poorer outcome compared to the “typical” results. Professionals, patients, and laypeople are in agreement when assessing these outcomes.

scholarly journals Loneliness and Its Association With Social Media Use During the COVID-19 Outbreak

2021 ◽  
Vol 7 (3) ◽  
pp. 205630512110338
Author(s):  
Tore Bonsaksen ◽  
Mary Ruffolo ◽  
Janni Leung ◽  
Daicia Price ◽  
Hilde Thygesen ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Media Use ◽  
Age Groups ◽  
The United States ◽  
Social Media Use ◽  
Cross Sectional ◽  
Social And Emotional ◽  
Emotional Loneliness ◽  
Social Loneliness

Social distancing rules during the COVID-19 pandemic changed social interaction for many and increased the risk of loneliness in the general population. Social media use has been ambiguously related to loneliness, and associations may differ by age. The study aimed to examine loneliness and its association with social media use within different age groups during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, the United Kingdom, the United States, and Australia during April/May 2020, and 3,810 participants aged 18 years or above were recruited. Multiple regression analyses were conducted to examine associations between social media use and social and emotional loneliness within separate age groups. Emotional loneliness was higher among young adults and among those who used social media several times daily. Adjusting by sociodemographic variables, using more types of social media was associated with lower social loneliness among the oldest participants, and with higher emotional loneliness among the youngest participants. Among middle-aged participants, using social media more frequently was associated with lower social loneliness. We found that the associations between social media use and loneliness varied by age. Older people’s engagement on social media may be a resource to reduce loneliness during the COVID-19 pandemic. We observed higher levels of loneliness among high-frequent social media users of younger age.

scholarly journals Alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients using cone-beam computed tomography evaluation

2021 ◽  
Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Contralateral Side ◽  
Cone Beam ◽  
Rank Test ◽  
Cross Sectional ◽  
Alveolar Bone Grafting

Abstract Purpose The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients and methods The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. Results The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. Conclusion The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.

Understanding How to Strengthen the Neurology Pipeline With Insight From Undergraduate Neuroscience Students

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013259
Author(s):  
Mia Minen ◽  
Kayla Kaplan ◽  
Sangida Akter ◽  
Dennique Khanns ◽  
Tasha Ostendorf ◽  
...  
Keyword(s):  
Liberal Arts ◽  
Research University ◽  
Online Survey ◽  
Approaches To Learning ◽  
The United States ◽  
Clinical Neurology ◽  
Graduate Studies ◽  
Cross Sectional ◽  
Research Experiences ◽  
Undergraduate Level

Despite increased neuroscience interest at the undergraduate level, a significant shortage of neurologists in the United States (US) exists. To better understand how to generate more interest in neurology specifically at the undergraduate level, we conducted an anonymous cross-sectional online survey of 1085 undergraduates either in neuroscience courses or majoring/minoring in neuroscience from across the US to better understand their clinical neurology experiences and perspectives. The survey quantitatively and qualitatively assessed students’ clinical neurology exposure inside and outside of the classroom, research experiences and career goals. Students were from a broad spectrum of undergraduate institutions (public research university (40.8%), liberal arts College (29.7%) and private research university (29.0%). Most students (89.9%) were looking to pursue graduate studies; 56.9% reported wanting to be a physician and 17.8% expressed interest in obtaining an MD/PhD. Importantly, students reported first exposure to neuroscience at age 16 but felt that they could be exposed to neuroscience as early as 13. Half (50.5%) decided to major in neuroscience before college and a quarter (25.6%) decided to major in their first year of college. Despite high interest in clinical neurology exposure, less than one-third of students had spoken with or shadowed a neurologist, and only 13.6% had interacted with clinical neurology populations. Only 20.8% of students felt volunteer and internship opportunities were sufficiently available. Qualitative results include student perspectives from those who did and did not work with a neurologist, describing how they were or were not able to obtain such opportunities. We discuss translating the survey findings into actionable results with opportunities to target the undergraduate neuroscience interest to improve the neurology pipeline. We describe existing programs that could be integrated into everyday neurology practices and new approaches to learning and training to help leverage the significant undergraduate neuroscience interest. We also raise questions for further research, including exploring (1) how students learn of neurologic conditions/expand their knowledge about additional neurologic conditions, (2) whether qualitative investigation of the experiences of neuroscience undergraduates at specific institutions might provide additional insight, and (3) systems to maintain interest in neuroscience/neurology as students enter medical school.

scholarly journals Corelation Of Parents’ Profiles Of Children With Late Cleft Repair In Surabaya Cleft Lip And Palate Centre (January 2015 – December 2017)

2021 ◽  
Vol 5 (1) ◽  
pp. 18
Author(s):  
Laras Puspita Ningrum ◽  
Iswinarno Doso Saputro ◽  
Lobredia Zarasade
Keyword(s):  
Cleft Palate ◽  
Primary Care Physicians ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Education Level ◽  
Optimal Time ◽  
Cross Sectional ◽  
Cleft Palate Repair ◽  
Palate Repair

Background : Optimal time of  Cleft palate repair is during the 10 to 12  month of age. In this time produce far natural results in terms of speech because it enabled the maturation of scar tissue postoperatively. The soft palate must function properly before the patient starts learning to talk, otherwise speech disorders such as persistent rhinolalia aperta might arise. In pediatric patients, the role of parents is very important on adherence to therapy.Methods: This is a cross-sectional study. The first study group was parents of patients who had surgical repair before two years old and the second group was the parents of patients who had repair after two years old. We compared age, monthly income, education level, number of children, and residential distance from Surabaya of the two groups.Results : The data of this study were obtained from the medical records of patients with cleft lip surgery at CLP Center Surabaya in 2015th – 2017th with total of 358 patients, 172 were female and 186 were male. 52 patients with delayed cleft palate surgery. Patients’ parents in both groups were mostly 31-40 years old, were high school graduated, has one child, earned less than 1.5 million rupiah a month, and lived less than 100 kms from Surabaya. From the statistical results, parent’s income has the strongest correlation with the patient’s age in cleft palate surgery (-2.7). A negative coefficient means that the less parent’s income, the more patient likely had delayed cleft palate surgery. While other factors found weak and very weak correlations.Conclusions: The results form patient's parents' interview, concluded that besides economic factors, the lack of information cleft palate treatment is the key factors that contributed to the delay of cleft palate repair. The education level does not affect the delay in cleft palate surgery, because even in high educated parents, sometimes they don’t understand the stages of cleft lip and palate treatment. This study emphasized the necessity to educate about the stages of surgery by primary care physicians, to minimize delays.

scholarly journals Antropometric Evaluation Of Gentur's Cheiloplasty Method In Unilateral Cleft Lip

2017 ◽  
Vol 3 (2) ◽  
pp. 52-60
Author(s):  
Rani Septrina ◽  
Gentur Sudjatmiko
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
Before And After ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Palate Patient ◽  
Vertical Height ◽  
Rotation Advancement

Background: Cheiloplasty, the earliest surgical procedure in cleft lip and palate patient, has impact on functional and aesthetical appearance1. The Gentur’s technique is a method of cleft lip surgery that has been developed by him and has been used in RSUPN Cipto Mangunkusumo/Faculty of Medicine Universitas Indonesia2. It uses the rotation-advancement, small triangular, preventing notching concepts with some other details to overcome the wide cleft. This study was conducted to answer whether the Gentur’s technique gives symmetrical result in anthropometric measurements. Methods: Cross sectional analytic study will be taken from medical record in 14 unilateral cleft lip patients underwent cheiloplasty procedure. Direct anthropometric data before and after procedure were analyzed using SPSS17. Anthropometric data such as cupid’s bow, vertical height, horizontal height, vermillion and nostril were noted. Results: From 14 patients, we found 9 patients who underwent surgery in 3 months of age (64.3%) are mostly female (n=9, 64.3%), have complete defect (n=12, 85.8%) and left sided defect (n=8, 57.1%). Gentur’s technique is able to produce significant lip and nose symmetry (CI 95%, pvalue <0.005) in cupid’s bow, vertical height, horizontal height, thickness of vermillion and nose. By doing this technique, the author is able to create good lip and nose symmetry (78.57%) even in wide defect (64.3%) and palatal collapse (57.1%). Conclusion: Gentur’s technique is able to utilize tissue deficiency to create ideal lip and nose in unilateral cleft lip repair even in patients with wide gap.

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