Avaliação da alimentação em crianças com fissura de lábio e/ou palato atendidas em um hospital de Porto Alegre

Abstract

OBJETIVO: avaliar a alimentação de crianças fissuradas e descrever suas características; verificar o tipo de alimentação e suas dificuldades alimentares. MÉTODOS: foi um estudo quantitativo, transversal, observacional e descritivo. Participaram 23 pacientes fissurados de zero a nove anos, que realizaram avaliação do sistema estomatognático e cujos responsáveis foram entrevistados. Realizou-se análise estatística descritiva dos dados obtidos na avaliação, assim como análise teórica. RESULTADOS: o tipo de fissura mais encontrada foi a Fissura Transforame Unilateral. Das 23 crianças, duas (8,75%) foram amamentadas exclusivamente. As maiores dificuldades alimentares foram: seis (26,1%) dificuldade para sugar, 10 (43,5%) engasgos, quatro (17,4%) dificuldade para deglutir, três (13,0%) dificuldade para mastigar e 12 (52,2%) tinham refluxo nasal. As alterações das funções do Sistema Estomatognático mais frequentes foram a interposição lingual importante na deglutição e mastigação do tipo mascagem. CONCLUSÃO: a fissura transforame, mesmo sendo mais complexa, não excluiu o aleitamento materno exclusivo; o tipo de alimentação relacionado com a idade dos pacientes apresenta-se de maneira adequada; boa parte dos pacientes ainda usa a mamadeira com bico comum, constituindo um hábito deletério. As maiores dificuldades na alimentação relatadas pelas mães foram engasgos, refluxo nasal e dificuldade de sugar. As crianças que não apresentaram queixas de dificuldade de alimentação eram portadoras, na sua maioria, de fissura pré-forame incisivo.

Sintomas de disfagia em crianças com fissura labial e/ou palatina pré e pós-correção cirúrgica

“…Although with greater difficulty, infants with CLP are able to succeed in the process of exclusive breastfeeding (6,21) , considering adequate positioning and adjustments to breastfeeding intervals (8) . The low number of participants in this study who were breast fed, as well as the short length of time in this feeding route, are in agreement with findings in the literature (4,10) , and they reinforce the importance of the presence of trained professionals in care teams at birth.…”

“…Changes in the oropharyngeal structures caused by CLP are considered risk factors for the development of dysphagia. The degree and characteristics of eating difficulties in this population are directly associated with the extent and type of the cleft (5,10,11) . The objective of this study was to determine the occurrence of dysphagia symptoms in children with cleft lip and/or palate pre-and postoperatively.…”

“…Classification of dysphagia impairment in pediatrics, using an assessment protocol, is as follows: normal swallowing, mild oropharyngeal dysphagia, moderate to severe oropharyngeal dysphagia, and severe oropharyngeal dysphagia (9) . The most common symptoms of dysphagia are anterior escape; premature posterior food escape; reduction of oral sensitivity; delayed onset of swallowing; laryngeal penetration or laryngotracheal aspiration, generating signs such as coughing, choking, and vomiting during or after eating (9,10) . Dysphagic children may present delayed development of oral motor functions, chronic respiratory diseases, gastroesophageal reflux, weight loss, malnutrition, and selectivity of foods and consistencies (11) .…”

“…Dysphagic children may present delayed development of oral motor functions, chronic respiratory diseases, gastroesophageal reflux, weight loss, malnutrition, and selectivity of foods and consistencies (11) . Studies have reported that the main complaints of mothers about the initial feeding process of children with CLP are nasal reflux, choking, coughing, and difficulties in the sucking process (8,10) . In cases of CLP, there are difficulties in establishing efficient and safe suction due to weak intraoral pressure during the performance of this function, as well as to disorders in the suction/deglutition/respiration coordination.…”

Orofacial clefts in Brazil and surgical rehabilitation under the Brazilian National Health System

“…1,3 In addition to aesthetic deformation, orofacial cleft patients may experience significant functional changes, which include maxillofacial growth restriction, dental alterations, disturbances in speech, swallowing and feeding difficulties, recurrent ear infections and hearing loss. 4,5,6,7 These changes affect the health and quality of life of individuals with orofacial clefts and their families. 8 The great clinical variety of OFCs, together with their many degrees of severity and possible association with other syndromes or birth defects, results in different treatment protocols.…”