scholarly journals Maternal perception of breastfeeding in children with unilateral cleft lip and palate: a qualitative research work

2020 ◽  
Author(s):  
Ana María María Cerón-Zapata ◽  
Cecilia María Martínez-Delgado ◽  
Gloria Emilia Calderón-Higuita

Abstract BackgroundUnilateral cleft lip and / or palate (UCLP) is one of the most common congenital craniofacial abnormalities. The objective of this study was to describe maternal perception of breastfeeding in children with unilateral cleft lip and palate and to assess the role of breastfeeding counseling. MethodsQualitative descriptive method and phenomenological analysis were used to analyze the narratives. 28 mothers of patients with nonsyndromic UCLP treated with Nasoalveolar molding (NAM) between April 2015 and April 2017 were strategically selected and interviewed. Framework analysis was conducted for qualitative data. The CES University ethical committee approved the study. ResultsThe findings resulted in six main categories. First, contact with the CLP program, access to early diagnosis and timely treatment, perceptions of parents about health personnel on breastfeeding of CLP patients, perceptions of mothers toward breastfeeding, perception of advantages and disadvantages of the NAM technique regarding breastfeeding and assessment of the CLP program. ConclusionThe participants related difficulties with breastfeeding. Mothers acknowledged the clinical results when using the NAM obturator, as well as the support provided by the breastfeeding consultant.

2021 ◽  
Author(s):  
Ana María Cerón-Zapata ◽  
María Cecilia Martínez-Delgado ◽  
Gloria Emilia Calderón-Higuita

Abstract Background : Unilateral cleft lip and / or palate (UCLP) is one of the most common congenital craniofacial difference. The objective of this study was to describe maternal perception of breastfeeding in children with unilateral cleft lip and palate and to assess the role of breastfeeding counseling. Methods : Qualitative descriptive method and phenomenological analysis were used to analyze the narratives. 28 mothers of patients with nonsyndromic UCLP treated with nasoalveolar molding (NAM) between April 2015 and April 2018 were strategically selected and interviewed after NAM treatment. Framework analysis was conducted for qualitative data. The CES University ethical committee approved the study. Results : The findings resulted in six main categories: First contact with the CLP program, access to early diagnosis and timely treatment, perceptions of parents about health personnel on breastfeeding of CLP patients, perceptions of mothers toward breastfeeding, perception of advantages and disadvantages of the NAM technique regarding breastfeeding and assessment of the CLP program. The interviewed mothers, both prenatally and postnatally, stated the advantages of initiating the process prenatally. There are still difficulties for reaching a timely diagnosis. Several mothers stated that health professionals and assistants determined the hospitalization, installation of a nasogastric tube or feeding through a baby bottle or syringe, which prevented the first contact between mother and child. Even though the breastfeeding process is difficult for these mothers, they acknowledged its immense advantages. Interviewed mothers considered the use of the NAM advantageous as the obturator allowed a better bottle-feeding process. The program generates satisfaction, motivation, expectations and happiness to the mothers who initiated this therapy with their children. Conclusion : The participants related difficulties with breastfeeding. Mothers acknowledged the clinical results when using the NAM obturator, as well as the support provided by the breastfeeding consultant.


2021 ◽  
Vol 8 ◽  
Author(s):  
Mohamed Azhari ◽  
Wijdane El Hawari ◽  
Hasnae Rokhssi ◽  
Nadia Merzouk ◽  
Oussama Bentahar

Statement of problem. Cleft Lip and Palate (CLP) are common congenital defects of the present day. They result from a failure of facial bud sticking during embryological phenomena. Their therapeutics based on multi-disciplinary care to restore as much as possible the aesthetic and functional prejudices generated by these anomalies. Purpose. Through this work, we will illustrate, through a clinical case supported at the Consultation and Dental Treatment Center of Rabat, clinical and laboratory stages of realization of Nasoalveolar Molding (NAM). Material and methods. We describe original techniques used in our service for manufacturing of NAM fireworks and we define recommendations after insertion and follow-up procedures.Result. Place of NAM in management of these anomalies has increasingly recommended, given limitations of surgery alone to ensure satisfactory aesthetic results. Several fixed or removable appliances has used, in order to reposition gaps in cleft and / or to reshape affected bordering tissues. Conclusion. Despite the controversies surrounding this therapy, it remains highly recommended and scientifically based.


Author(s):  
Santosh Kumar

Background: Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of Presurgical Nasoalveolar Molding (PNAM) on Midface symmetry in children treated for CUCLP. Material and Methods: This case-control study was carried out in the Department of Burn and Plastic Surgery at Government Medical College and Hospital, Bettiah, Bihar, India from may 2018 to Dec 2019. Complete unilateral CL+P patients had basilar and frontal photographs at two time points: (1) initial (2) postsurgical. 30 nasal molding patients and 20 control patients were included. Presurgical nasal molding was performed prior to primary lip repair in intervention group. No nasal molding was performed in control group. Results: A statistically significant difference was found for postsurgical nostril height-width ratio (P< .05). No other statistically significant differences were found. Conclusion: Nasal molding and surgery resulted in more symmetrical nostril height-width ratios than surgery alone. Alar groove ratios were not statistically significantly different between groups perhaps because application of nasal molding was not early enough; postsurgical nasal splints were not utilized; overcorrection was not performed for nasal molding


2018 ◽  
Vol 55 (5) ◽  
pp. 655-663 ◽  
Author(s):  
Supakit Peanchitlertkajorn ◽  
Ana Mercado ◽  
John Daskalogiannakis ◽  
Ronald Hathaway ◽  
Kathleen Russell ◽  
...  

Objective: To compare nasolabial appearance outcomes of patients with complete unilateral cleft lip and palate (CUCLP) in preadolescence from 4 cleft centers including a center using nasoalveolar molding (NAM) and primary nasal reconstruction. Design: Retrospective cohort study. Setting: Four cleft centers in North America. Patients: 135 subjects with repaired CUCLP. Methods: Frontal and profile facial pictures were assessed using the Asher-McDade rating scale. Intra- and interrater reliability were tested using weighted Kappa statistics. Median scores by center were compared with Kruskal-Wallis statistics. Results: Intrarater reliability scores were moderate to good. Interrater reliability scores were moderate. Significant differences ( P < .05) among centers were found. For nasal form, center G (median = 2.83) had better scores than centers C and D (C median = 3.33, D median = 3.17). For nose symmetry, center G had better scores (median = 2.33) than all other centers (B median = 2.67, C median = 2.83, D median = 2.83). For vermillion border, center G had better scores (median = 2.58) than centers B and C (B median = 3.17, C median = 3.17). For nasolabial profile, center G (median score = 2.67) had better scores than center C (median = 3.00). For total nasolabial score, center G (median = 2.67) had better scores than all other centers (B median = 2.83, C median = 3, D median = 2.83). Conclusion: The protocol followed by center G, the only center that performed NAM and primary nasal reconstruction, produced better results in all categories when compared to center C, the only center that did not perform presurgical orthopedics or lip/nose revisions. When compared to centers that performed traditional presurgical orthopedics and surgical revisions (B and D), center G was not consistently better in all categories. As with other uncontrolled, retrospective intercenter studies, it is not possible to attribute the outcomes to a specific protocol component.


Sign in / Sign up

Export Citation Format

Share Document