Breastfeeding After Early Repair of Cleft Lip in Newborns With Cleft Lip or Cleft Lip and Palate in a Baby-Friendly Designated Hospital

Burianová, Iva; Kulihova, Katarina; Vítková, Veronika; Janota, Jan

doi:10.1177/0890334417706062

Cited by 24 publications

(15 citation statements)

References 10 publications

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“…While advantages of ECLR include improved aesthetic outcomes, wound healing, and parental mental health (Burianova et al, 2017), there is persistent concern regarding the effects of anesthetic agents on neonatal neurological development. Our institution developed a novel DBNAP for patients undergoing ECLR without any increase in adverse events compared to traditional volatile anesthetic agents (Wlodarczyk et al, 2021b).…”

Section: Discussionmentioning

confidence: 99%

Rethinking the Rule of 10s: Early Cleft Lip Repair Improves Weight Gain

Kondra

Stanton

Jimenez

et al. 2021

The Cleft Palate Craniofacial Journal

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Objective This study compares patients undergoing early cleft lip repair (ECLR) (<3-months) and traditional lip repair (TLR) (3-6 months) with/without nasoalveolar molding (NAM) to evaluate the effects of surgical timing on weight gain in hopes of guiding future treatment paradigms. Design Retrospective review. Setting Children's Hospital of Los Angeles, California. Patient, Participants A retrospective chart review evaluated patients who underwent ECLR or TLR ± NAM from November 2009 through January 2020. Interventions No intervention was performed. Main Outcome Measure(s) Patient demographics, birth and medical history, perioperative variables, and complications were collected. Infant weights and age-based percentiles were recorded at birth, surgery, 8-weeks, 6-months, 12-months, and 24-months postoperatively. The main outcomes were weight change and weight percentile amongst ECLR and TLR ± NAM groups. Results 107 patients met inclusion criteria: ECLR, n = 51 (47.6%); TLR + NAM, n = 35 (32.7%); and TLR-NAM, n = 21 (19.6%). ECLR patients had significantly greater changes in weight from surgery to 8-weeks and from surgery to 24-months postoperatively compared with both TLR ± NAM ( P < .05). Age-matched weights in the ECLR group were significantly greater than TLR ± NAM at multiple time points postoperatively ( P < .05). Conclusions ECLR significantly increased patient weights 24-months postoperatively when compared to TLR ± NAM. Specifically compared to TLR-NAM, ECLR weights were significantly greater at all time points past 6-months postoperatively. The results of this study demonstrate that ECLR can mitigate feeding difficulties and malnutrition traditionally seen in patients with cleft lip.

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Section: Discussionmentioning

confidence: 99%

Rethinking the Rule of 10s: Early Cleft Lip Repair Improves Weight Gain

Kondra

Stanton

Jimenez

et al. 2021

The Cleft Palate Craniofacial Journal

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show abstract

“…Other studies focused on the growth outcome and the frequency of postoperative complications and did not determine mode of nutrition (Bessell et al, 2011; Zhang et al, 2017). Our data from one cohort of infants delivering in BFHI hospital showed a high breastfeeding rate in the CL group (78%; Burianova et al, 2017).…”

Section: Discussionmentioning

confidence: 63%

Duration of Surgery, Ventilation, and Length of Hospital Stay Do Not Affect Breastfeeding in Newborns After Early Cleft Lip Repair

Burianová

Černý

Borský

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: There are minimal data available on nutrition after early repair of cleft lip and the factors influencing initiation of breastfeeding. This study assessed the impact of the length of surgery, length of ventilation support, and duration of hospital stay on breastfeeding rates after early cleft lip surgery. Design: This is a prospective observational cohort study comparing 2 hospitals providing early surgical repair of facial clefts from January 2014 to December 2016. Both hospitals are designated as Baby-Friendly Hospitals. Demographic and anthropometric data from mothers and newborns were recorded. Setting: Tertiary neonatal and pediatric surgery center. Patients: Hospital A: 61 newborns, Hospital B: 157 newborns. Interventions: Early (day 5 to 14) cheiloplasty in newborns with cleft lip or cleft lip and palate. Main Outcome Measures: Influence of duration of hospital stay, length of operation, and artificial ventilation on the rate of breastfeeding. Results: Significantly, more newborns were breastfed following early surgical repair of an isolated cleft lip compared to those with both cleft lip and palate, in both hospitals (hospital A 82% vs 0%, P = .0001, hospital B 66% vs 5%, P = .0001). Duration of hospital stay, length of operation, and duration of artificial ventilation did not significantly affect the rate of breastfeeding. Conclusions: The factors associated with early cleft lip repair (length of operation, length of ventilation support, and duration of hospital stay) do not affect breastfeeding rate.

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“…Parents with CL/P may not be aware of the possibility of accomplishing breastfeeding (Burianova et al, 2017) or assisted nursing. Peer support groups for mothers with CL/P who have experience breastfeeding are essential (Santos et al, 2019), but lacking.…”

Section: Discussionmentioning

confidence: 99%

Assisted Nursing: A Case Study of an Infant With a Complete Unilateral Cleft Lip and Palate

Lopez-Bassols

2020

J Hum Lact

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Background This case presents a mother’s feeding experience of an infant born with a complete unilateral cleft lip and palate from birth until both were repaired. She fed him directly at the breast with assistance, controlling the delivery of the mother’s own milk. The infant received only his mother’s own milk, no bottles, and the excess expressed milk was donated to a milk bank. Main issue The Cleft Team supported the mother’s wish to breastfeed but expressed realism that cleft lip and palate infants could not create suction. Success had never been observed in the unit. Instead, the team suggested expressing to deliver as much of the mother’s own milk. The mother had previously breastfed her three children and was keen on finding innovative ways to breastfeed. Management Several techniques were trialed with the help of an International Board Certified Lactation Consultant. The most sustainable and successful was the use of a nipple shield applied to the maternal nipple areola complex to cover the lip palate. Underneath, a nasogastric tube connected to a syringe delivered the mother’s own milk. Exclusive expressing protected maternal supply, the infant’s nutrition and growth were monitored carefully and this technique reinforced mother–infant bonding. Conclusion Feeding with the modifications was challenging at times. However, maternal satisfaction was high because the mother had achieved her goal of breastfeeding without assistance post cheiloplasty and palatoplasty. This case adds to the limited body of research about feeding infants with cleft lips and palates directly at the breast.

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Breastfeeding After Early Repair of Cleft Lip in Newborns With Cleft Lip or Cleft Lip and Palate in a Baby-Friendly Designated Hospital

Abstract: The rate of breastfeeding in patients following early surgery of the cleft lip was high and comparable to the general population. The rate of breastfeeding in babies with cleft lip and palate after early repair of the cleft lip remained low.

Cited by 24 publications

References 10 publications

Rethinking the Rule of 10s: Early Cleft Lip Repair Improves Weight Gain

Rethinking the Rule of 10s: Early Cleft Lip Repair Improves Weight Gain

Duration of Surgery, Ventilation, and Length of Hospital Stay Do Not Affect Breastfeeding in Newborns After Early Cleft Lip Repair

Assisted Nursing: A Case Study of an Infant With a Complete Unilateral Cleft Lip and Palate

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