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A prospective, longitudinal study of feeding skills in a cohort of babies with cleft conditions
Julie Reid1, Nicky Kilpatrick, Sheena Reilly
1Murdoch Children's Research Institute and Speech Pathology Department, Royal Children's Hospital, Flemington Road, Parkville 3052, Victoria, Australia. julie.reid@rch.org.au
Insights
Feeding difficulties are common in newborns with clefts, but improve over time. Babies with Pierre Robin sequence (PRS) or syndromes face higher risks for persistent feeding issues.
Area of Science:
- Pediatric feeding disorders
- Craniofacial anomalies
- Developmental pediatrics
Background:
- Feeding difficulties are a significant concern for infants with cleft palate and cleft lip and palate.
- Understanding the natural progression and risk factors is crucial for early intervention.
Purpose of the Study:
- To investigate the developmental trajectory of feeding skills in infants with clefts.
- To identify risk factors and predictors associated with poor feeding outcomes.
Main Methods:
- Longitudinal study of 62 infants with clefts assessed at 2 weeks, 3 months, and 14 months.
- Evaluated feeding ability, oral motor function, and feeding efficiency.
- Utilized univariate and multivariable logistic regression analyses to identify risk factors.
Main Results:
- One-third of newborns with clefts exhibited poor feeding skills, decreasing to 15% by 14 months.
- Oral motor dysfunction and nasal regurgitation were common in infants with feeding difficulties.
- Syndromic conditions or Pierre Robin sequence (PRS) were major risk factors, increasing likelihood of poor feeding by 15 times at 2 weeks.
Conclusions:
- Poor feeding is prevalent in newborns with clefts, often requiring intervention beyond infancy.
- Infants with PRS or associated syndromes require particular attention for feeding support.
Objective:
To examine the natural history of feeding skills in babies with clefts and identify risk factors and predictors of poor feeding.
Participants:
Sixty-two babies with clefts were examined at 2 weeks, 3 months, and 14 months of age.
Main Outcome Measures:
Feeding ability, oral motor function, and feeding efficiency were assessed. Univariate analyses were used to determine whether oral motor function and sequelae varied according to feeding ability or cleft condition. Multivariable logistic regressions were used to determine risk factors for poor feeding.
Results:
Poor feeding skills were detected in one third of newborns. The prevalence of poor feeding reduced to 19% at 3 months of age and 15% at 14 months of age. Oral motor dysfunction and sequelae (particularly nasal regurgitation) were more commonly observed in babies with poor feeding skills irrespective of comorbidity. The main risk factor for poor feeding was a diagnosis of syndrome or Pierre Robin sequence (PRS). At 2 weeks of age, babies with syndrome or PRS were 15 times more likely to have poor feeding skills than their nonsyndromic counterparts. When syndrome or PRS was controlled for, babies with cleft palate and cleft lip and palate were equally likely to have poor feeding skills. Parental report of feeding efficiency was predictive of poor feeding in young babies.
Conclusions:
Poor feeding skills are relatively common in newborns with cleft palate and cleft lip and palate. Treatment for feeding problems may be needed beyond the first year of life, especially for babies born with PRS or a syndrome.
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