This literature review investigates the effects of feeding interventions (e.g., feeding equipment, feeding techniques, breast-feeding, prosthese, nutrition/lactation advice) on feeding difficulties in infants with cleft conditions.
Not stated
1955-2002
Not further specified
55
"The evidence underpinning many (91%) of the feeding interventions described for cleft palate infants and reviewed in this article was considered weak" (Level IV Evidence; p. 276). "Although the outcomes reported were essentially positive, they were drawn from a relatively small body of literature where the heterogeneity of samples, inclusion of multiple interventions in a single protocol, lack of controls, lack of replication, and failure to use rigorous methods confounded interpretation of results" (p. 276).
"Only five published data-driven studies yielded limited-to-strong evidence to guide clinicians when choosing feeding options for young infants with unrepaired cleft palate or cleft lip and palate" (Level III.3 to Level II Evidence; p. 276).The included studies investigated combinations of interventions (e.g., nutrition intervention and compressible bottles). <br /><br />"Data from these studies suggested that feeding education... delivered with a nutrition intervention protocol... can improve outcomes such as weight gain, feed velocity, and fluid intake for cleft infants" (p. 276). Results also demonstrated the following feeding equipment combinations to positively influence the participants' growth and weight gain:
<ul>
<li>compressible bottes used with a NUK orthodontic nipple;</li>
<li>cleft palate feeders; or </li>
<li>crosscut nipples used with a standard rigid bottle.</li>
</ul>
"At present,there is limited but promising evidence to support the use of palatal obturators and lactation education (such as advice on positioning, bottle use, feed duration, infant feeding cues, and breast-feeding techniques) to improve both breast- and bottle-feeding outcomes for infants with cleft palate or combined cleft lip and palate" (p. 276).
