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.

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 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.

Initial Nutritional Assessment of Infants with Cleft Lip and/or Palate: Interventions and Return to Birth Weight

2017 ◽  
Vol 54 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Alison Kaye ◽  
Kristi Thaete ◽  
Audrey Snell ◽  
Connie Chesser ◽  
Claudia Goldak ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nutritional Assessment ◽  
Initial Assessment ◽  
Average Birth Weight ◽  
Nutritional Interventions

Objective To assess and quantify cleft team practices with regard to nutritional support in the neonatal period Design Retrospective review. Setting Tertiary pediatric hospital. Patients One hundred consecutive newborn patients with a diagnosis of cleft lip and/or cleft palate between 2009 and 2012. Main Outcome Measures Birth weight, cleft type, initial cleft team weight measurements, initial feeding practices, recommended nutritional interventions, and follow-up nutritional assessments. Results All patients in the study were evaluated by a registered dietitian and an occupational feeding therapist. Average birth weight and average age at the first cleft team visit were similar for each cleft type: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP). The calculated age (in days) for return to birth weight was significantly different between cleft types: CL = 13.58 days, CLP = 15.88 days, and CP = 21.93 days. Exclusive use of breast milk was 50% for patients with CL, 30.3% for patients with CLP, and 21.4% for patients with CP. Detailed nutritional interventions were made for 31 patients at the first visit: two with CL, 14 with CLP, and 15 with CP. Conclusions Distinct differences were seen in neonatal weight gain between cleft types. There was significantly greater total weight gain for patients with CL at their first visit and significantly slower return to birth weight for patients with isolated CP. Patients with CL required far fewer interventions at the initial assessment and were more likely to be provided breast milk exclusively or in combination with formula. Infants with CP were far less likely to receive any breast milk. Patients with CLP and CP required frequent nutritional interventions.

Population-Based Study on the Practice of Breastfeeding in Children Born with Cleft Lip and Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 687-693 ◽  
Author(s):  
Letícia W. Garcez ◽  
Elsa R. J. Giugliani
Keyword(s):  
Cleft Palate ◽  
Median Duration ◽  
Exclusive Breastfeeding ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Population Based ◽  
Breastfeeding Duration ◽  
Porto Alegre ◽  
Initiation Rate ◽  
Population Based Study

Objective To investigate the practice of breastfeeding and related difficulties in children born in Porto Alegre, Brazil, with cleft lip, cleft palate, and cleft lip with cleft palate. Design Cohort, observational, and population-based study. Population and Sample Mothers of all children born in 2001 and 2002 with cleft lip and palate in the city of Porto Alegre, Brazil (n = 31), were interviewed in their homes. From the information collected, the frequencies of breastfeeding and exclusive breastfeeding in the first year of life were estimated and the median duration was computed according to the type of cleft. A descriptive analysis was used to study the difficulties. Main Indicators Initiation rate, pattern, duration, and difficulties of breastfeeding and exclusive breastfeeding. Results The initiation rate of breastfeeding was 100% and its median duration was 42.5 days. Exclusive breastfeeding was initiated by 67.7% of the sample and maintained for 15 days (median). The breastfeeding duration was significantly higher in the presence of cleft lip, being equal or even superior to (in the case of exclusive breastfeeding) the median of Porto Alegre's general population. The most frequently mentioned difficulties were weak suction, difficulty attaching to the breast, and breast milk escaping through the nostrils. Conclusions In spite of the diverse difficulties reported and the lack of professional support after discharge from the maternity wards, the initiation rate and the duration of breastfeeding of children with cleft lip and palate found in this study reinforce the theory that this malformation, especially cleft lip, is compatible with successful breastfeeding.

Talon Cusp Associates With MMP2 in a Cohort of Individuals Born With Oral Clefts

2020 ◽  
pp. 105566562095856
Author(s):  
Bianca G. N. Cavalcante ◽  
Rosa Helena W. Lacerda ◽  
Ionária O. Assis ◽  
Mariana Bezamat ◽  
Adriana Modesto ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Development ◽  
Internal Anatomy ◽  
Dental Anomalies ◽  
Extended Phenotype ◽  
Nucleotide Polymorphism ◽  
Chi Square ◽  
Single Nucleotide ◽  
Oral Clefts

Objective: The aim of this study was to use dental development as a tool to subphenotype oral clefts and investigate the association of MMP2 with dentin-pulp complex anomalies, in order to identify dental anomalies that are a part of a “cleft syndrome.” Design: Two hundred and ninety individuals born with cleft lip and palate were evaluated and several clinical features, such as cleft completeness or incompleteness, laterality, and presence of dental anomalies were used to assess each individual’s cleft status. We tested for overrepresentation of MMP2 single nucleotide polymorphism rs9923304 alleles depending on individuals having certain dental anomalies. Chi-square and Fisher exact tests were used in all comparisons (α = .05). Results: All individuals studied had at least one dental anomaly outside the cleft area. Significant differences between individuals born with clefts with and without talon cusp ( P = .04) were observed for the frequency of the MMP2 less common allele. Conclusion: All individuals born with cleft lip and palate had alterations of the dentition, and a quarter to half of the individuals had alterations of the internal anatomy of their teeth, which further indicates that dental anomalies can be considered as an extended phenotype for clefts. MMP2 was associated with talon cusp in individuals born with oral clefts.

Analysis of the Prevalence and Incidence of Cleft Lip and Palate in Colombia

2019 ◽  
Vol 57 (5) ◽  
pp. 552-559 ◽  
Author(s):  
Rengifo Reina Herney Alonso ◽  
Guarnizo Peralta Stefany Brigetty
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Oral Clefts ◽  
Birth Prevalence ◽  
Administrative Records ◽  
Live Births ◽  
Population Prevalence ◽  
The Individual

Objective: To analyze the population prevalence and birth prevalence of oral clefts in Colombia from 2009 to 2017. Methods: A cross-sectional study using information from the National Administrative Records of Colombia. The data came from 2 types of administrative records (Surveillance System and the Individual Registry of Service Provision) and the oral health national survey. Population prevalence and birth prevalence by type of cleft lip and/or cleft (CL/P) ratios were calculated using Poisson distribution for count data and to assess stationary tests on time series (Dickey-Fuller) and (Phillips-Perron) was used. Results: Population prevalence in Colombia was 3.27 per 10 000 inhabitants (95% confidence interval [CI], 3.21-3.32) and birth prevalence was 6.0 per 10 000 live births (95% CI, 5.67-6.35). Bogotá have the highest population prevalence with CL/P. In the analysis of trends for the prevalence proportion by type of clefts in newborn babies with cleft, it was observed that the highest proportion was for babies with CLP. Cleft lip (CL) has increased from 17.4% in 2014 to 34.2% in 2017, cleft palate (CP) has decreased from 32.9% to 20.2%; and CLP changed from 49.6% to 45.5% in the same period. Conclusions: The population prevalence was 3.27 per 10 000 inhabitants. Births prevalence was 6.0 per 10 000 live births, and Orinoquia and Amazonia have higher rates than the national average. The administrative registers are adequate systems to know the behavior of oral clefts. The CL/P had a nonstationary trend during the period 2014 to 2017.

Early Nutrition among Infants Admitted to the NICU with Cleft Lip and Palate

2021 ◽  
pp. 105566562110593
Author(s):  
Neda Tahmasebifard ◽  
Patrick M. Briley ◽  
Charles Ellis ◽  
Jamie L. Perry
Keyword(s):  
Human Milk ◽  
Neonatal Intensive Care ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Total Sample ◽  
Vital Statistics ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Logistic Regression Models ◽  
Milk Feeding

Objective The objective of this study was to examine differences in human milk feeding outcomes among infants admitted to a neonatal intensive care unit (NICU) with and without cleft lip and palate (CLP). Method Data were used from a sample of infants admitted to the NICU with and without CLP from the 2018 National Vital Statistics System. For baseline comparisons, Chi-square tests of independence were used to compare categorical variables, and independent samples t tests were used for continuous variables. Logistic regression models were performed to determine the odds of human milk feeding at discharge in infants admitted to the NICU with CLP. Results The total sample included 345,429 infants admitted to the NICU, of which 660 had CLP. Significant differences were found among the following variables when baseline comparisons were made between infants admitted to the NICU with and without CLP: mother's race, mother's education, maternal smoking record, childbirth delivery method, presence of maternal pre-pregnancy diabetes, five-minute APGAR score, multiparity record (having more than one baby at birth), gestational age, and gestational weight. After controlling for baseline differences, results indicated reduced odds of human milk feeding at discharge in infants admitted to the NICU with CLP compared to those without CLP (OR = .543; 95% CI.455,.648). Conclusion Results suggest reduced odds of human milk feeding at discharge among infants admitted to the NICU with CLP compared to those without CLP. These findings emphasize the necessity of awareness and facilitation of human milk feeding in this population.

A Randomized Control Trial Investigating the Effect of Presurgical Orthopedics on Feeding in Infants with Cleft Lip and/or Palate

2007 ◽  
Vol 44 (2) ◽  
pp. 182-193 ◽  
Author(s):  
A. G. Masarei ◽  
A. Wade ◽  
M. Mars ◽  
B. C. Sommerlad ◽  
D. Sell
Keyword(s):  
Motor Skills ◽  
Randomized Control Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mean Difference ◽  
Oral Motor ◽  
The North ◽  
Randomized Control ◽  
And Gender ◽  
Presurgical Orthopedics

Objective: To investigate the controversial assertion that presurgical orthopedics (PSO) facilitate feeding in infants with cleft lip and palate. Design: Randomized control trial of 34 infants with nonsyndromic complete unilateral cleft lip and palate and 16 with cleft of the soft and at least two thirds of the hard palate. Allocation to receive presurgical orthopedics or not used minimization for parity and gender. Other aspects of care were standardized. Setting: The North Thames Regional Cleft Centre. Main Outcome Measures: Measurements were made at 3 months of age (presurgery) and at 12 months of age (postsurgery). Primary outcomes were anthropometry and oral motor skills. Objective measures of sucking also were collected at 3 months using the Great Ormond Street Measure of Infant Feeding. Twenty-one infants also had videofluoroscopic assessment. Results: At 1 year, all infants had normal oral motor skills and no clear pattern of anthropometric differences emerged. For both cleft groups, infants randomized to presurgical orthopedics were, on average, shorter. The presurgical orthopedics infants were, on average, lighter in the unilateral cleft and lip palate group, but heavier in the isolated cleft palate group. Infants with complete unilateral cleft and lip palate randomized to presurgical orthopedics had lower average body mass index (mean difference PSO-No PSO: −0.45 (95% confidence interval [−1.78, 0.88]), this trend was reversed among infants with isolated cleft palates (mean difference PSO-No PSO: 1.98 [−0.95, 4.91]). None of the differences were statistically significant at either age. Conclusions: Presurgical orthopedics did not improve feeding efficiency or general body growth within the first year in either group of infants.

The Effects of Lactation Education and a Prosthetic Obturator Appliance on Feeding Efficiency in Infants with Cleft Lip and Palate

2001 ◽  
Vol 38 (5) ◽  
pp. 519-524 ◽  
Author(s):  
Leslie Turner ◽  
Cynthia Jacobsen ◽  
Margo Humenczuk ◽  
Virender K. Singhal ◽  
Dorsey Moore ◽  
...  
Keyword(s):  
Breast Milk ◽  
Flow Rate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Newborn Infants ◽  
Study Phase ◽  
Feeding Time ◽  
Good Growth ◽  
Breast Feed ◽  
Palatal Obturator

Objective: This prospective study examined the effect of lactation instruction and palatal obturation in decreasing time to feed, increasing intake, and on growth in eight breast milk bottle-fed newborn infants with cleft lip, cleft palate, or both. Design: An A, B1, C1, B2, and C2 reversal design was used with eight mothers. In A, baseline data on minutes fed by breast were recorded. In B1, baseline on minutes fed with a Haberman bottle was recorded. In C1, minutes fed following lactation education and palatal obturation were documented. Lactation education was information given to mothers to recognize infant feeding cues and to have infant-led feedings. The palatal obturator was a passive molding appliance. In B2, the obturator was removed and minutes fed noted. In C2, the obturator was returned and lactation support provided. Mothers kept feeding logs, satisfaction was assessed, and infant breast milk intake and flow rate were recorded during each study phase. Routine nutrition evaluation of weight, height, weight for height, and feed volume was completed by a registered dietitian during and following completion of the study. Results: Feeding times decreased with all infants, volume consumed increased with seven of eight infants, and flow rate increased with all infants. Mean feeding times during B1 and B2 phases (Haberman bottle only) were 34.4 and 32.3 minutes, respectively. Mean feeding times during C1 and C2 phases (obturation and lactation education) were 15.1 and 15.6 minutes. Volume of milk consumed during B1 and B2 feedings averaged 36.5 and 37 mL, compared with 67 mL and 76 mL during C1 and C2 phases. Growth as measured by height, weight gain, and weight for height during the study and the first 2 years of life compared favorably with that of children born without clefts. Conclusions: The combined use of a palatal obturator and lactation education reduced feeding time and increased volume intake and was associated with good growth. Mothers who had desired to breast-feed elected to use the obturator to support high-volume intake, decrease infant fatigue, and provide breast milk for nutrition.

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