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Feeding and Growth in Infants With Cleft Lip and/or Palate: Relationships With Maternal Distress
Lauren L Madhoun1,2, Canice E Crerand1,2,3,4, Meghan O'Brien1
1Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.
Objective:
To examine relationships between early feeding and growth and maternal distress in infants with and without cleft lip and/or palate (CL/P).
Design:
Cross-sectional.
Setting:
Pediatric academic medical center in the Midwestern United States.
Participants:
Mothers of infants 1 to 12 weeks old with CL/P (n = 30) and without CL/P (control group, n = 30) were recruited at craniofacial clinic or pediatrician appointments.
Main Outcome Measure(S):
Maternal responses on the Feeding/Swallowing Impact Survey (FS-IS), Parenting Stress Index, Fourth Edition, Short Form (PSI-4-SF), and Edinburgh Postnatal Depression Scale. Infant feeding history and growth measurements were obtained.
Results:
Having an infant with CL/P revealed greater impact on maternal health-related quality of life due to feeding problems (F = 4.83, P = .03). Mothers of infants with CL/P reported average range Total Stress scores on the PSI-4-SF, which were higher than controls (F = 4.12, P = .05). Edinburgh Postnatal Depression Scale scores did not differ between groups. Compared to controls, infants with cleft palate had lower percentiles for weight (t = 4.13, P = .04) and length (t = 2.93, P = .01). Higher FS-IS scores were associated with longer feeding duration (r = 0.32, P = .01) and lower weight (r = -0.31, P = .02) and length (r = -0.32, P = .02).
Conclusions:
Despite receiving early team care and feeding interventions, mothers of infants with CL/P reported higher stress and more challenges with feeding and growth. Future studies should examine targeted psychosocial interventions to improve feeding and growth outcomes in infants with CL/P.
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