120: Is Restricted Breast and Bottle-Feeding Necessary Following Cleft Lip Repair?

Dhaiban, Manal; Younas, Samreen; Channa, JA; Akhtar, Nasim

doi:10.1093/pch/19.6.e35-118

Cited by 2 publications

(4 citation statements)

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“…Substantial evidence exists to support returning immediately to bottle feeds after lip and palate repairs. [3][4][5][6][7][8][9][10][11] Spoon feeding is a skill for which children have no prior knowledge when done at lip repair. Similarly, open cup feeding may not have been introduced to the infant unless discussed with the parents well before surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The present study reports that although 88% of feeding providers recommend returning to bottle feeding immediately after lip repair, bottle feeding after palate repair is less common (55%). Substantial evidence exists to support returning immediately to bottle feeds after lip and palate repairs 3–11 . Spoon feeding is a skill for which children have no prior knowledge when done at lip repair.…”

Section: Discussionmentioning

confidence: 99%

“…Cohen and colleagues (1992) studied the difference between restrictive feeding, such as syringe or spoon feeding only, versus bottle feeding in infants after cheiloplasty and found no association between unrestricted bottle feeding and lip dehiscence. [3][4][5][6][7][8] Similarly, Assuncao (2005) studied the difference between spoon feeding and unrestricted bottle feeding and found no difference in nutritional status between spoon and bottle feeding while the infant is healing. 9 Despite these findings in support of immediately returning to bottle feeds after surgery, restrictive feeding is still a common practice in the United States.…”

mentioning

confidence: 99%

“…After lip repair, restrictive feeding protocols may include spoon or cup feeding only, even if spoon and cup feeding have not been previously introduced to the infant. Cohen and colleagues (1992) studied the difference between restrictive feeding, such as syringe or spoon feeding only, versus bottle feeding in infants after cheiloplasty and found no association between unrestricted bottle feeding and lip dehiscence 3–8 . Similarly, Assuncao (2005) studied the difference between spoon feeding and unrestricted bottle feeding and found no difference in nutritional status between spoon and bottle feeding while the infant is healing 9 .…”

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confidence: 99%

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Current Postoperative Feeding Practices Following Surgical Repairs for Infants With Cleft Palate

Williams

Kotlarek

2023

Journal of Craniofacial Surgery

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Background: Nearly all surgeons have restrictive postoperative feeding protocols in place after primary cleft lip and cleft palate repairs. There are no standardized recommendations, potentially resulting in widely variable practices among cleft surgeons and teams. The purpose of this study was to examine current postoperative feeding practices for infants with cleft palate after lip and palate repairs. Methods: A survey of 50 questions was sent to members of the American Cleft Palate-Craniofacial Association (ACPA). Inclusion criteria included providers from North America that have either currently or previously served on a cleft palate team and reached the surgical question set within the survey. Results: Sixty-four respondents met inclusion criteria. The majority were in speech-language pathology (47%) or nursing (41%) disciplines, involved in feeding consultations frequently (84%), and working in an outpatient setting (69%). After lip surgery, respondents recommended cleft-adapted bottle feeding (88%), spoon feeding (9%), cup feeding (13%), and syringe/squeeze bottle feeding (23%). The majority of respondents (69%) indicated infants could return to their preoperative feeding modality immediately after lip surgery. After palate surgery, respondents recommended cleft-adapted bottle feeding (55%), typical bottle feeding (3%), spoon feeding (36%), cup feeding (64%), and syringe/squeeze bottle feeding (30%). Infants could use a feeding system that required suction at an average of 20 days postoperatively and return to an age-appropriate diet at an average of 15 days postoperatively. Conclusions: The present study describes the wide variation of postoperative feeding guidelines used by cleft teams after lip and palate repairs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Current Postoperative Feeding Practices Following Surgical Repairs for Infants With Cleft Palate

Williams

Kotlarek

2023

Journal of Craniofacial Surgery

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Postoperative Feeding in Cleft Surgery: A Systematic Review

Fuentes,

Farsi,

Garcia

et al. 2024

The Cleft Palate Craniofacial Journal

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Introduction Postoperative feeding is crucial for the recovery of children after cleft surgery. The literature outlines diverse feeding methods with varying recommendations on the duration of non-nipple feeding postsurgery. This study aims to explore reported postoperative feeding modalities for infants undergoing primary cleft lip/palate repair, concentrating on their influence on feeding improvement and complication reduction. Methods PubMed, Cochrane, and Web of Science databases were queried for original English articles without any date restrictions. This review was conducted in accordance with the 2020 PRISMA. The MINORS criteria was used to assess quality of studies. Results Of 696 abstracts, 9 full-text articles were included, consisting of 459 children with cleft lip (n = 221) & cleft lip/palate (n = 238). Feeding modalities included bottle, breastfeeding, spoon, syringe, and nasogastric tube. Two studies found a significant increase in weight with breastfeeding compared to spoon or cup. Two studies found partial wound dehiscence using spoons, and two studies reported dehiscence using bottles. Post-palatoplasty, two studies showed a decrease in hospital stay in infants breastfed (2.1 & 5.8 days) vs spoon-fed (6 days). Analgesia was reduced in the breastfed group vs spoon/nasogastric tube. Conclusion This review highlights the importance of postoperative feeding in the recovery of infants with cleft lip/palate. Evidence suggests that breastfeeding may offer advantages in terms of weight gain and reduced hospital stay, while potentially minimizing the need for postoperative analgesia. The limited number of studies and variability in their outcomes underscore the need for further research to establish evidence-based guidelines for postoperative feeding.

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120: Is Restricted Breast and Bottle-Feeding Necessary Following Cleft Lip Repair?

Cited by 2 publications

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Current Postoperative Feeding Practices Following Surgical Repairs for Infants With Cleft Palate

Current Postoperative Feeding Practices Following Surgical Repairs for Infants With Cleft Palate

Postoperative Feeding in Cleft Surgery: A Systematic Review

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