Infant-Driven Feeding Systems: Do They "Normalize" the Feeding Experience of Infants With Cleft Palate?

Area of Science:

• Pediatric feeding
• Neonatology
• Craniofacial anomalies

Background:

• Infants with cleft palate with or without cleft lip (CP±L) often experience feeding difficulties.
• Specialized feeding systems are designed to mitigate these challenges.

Purpose of the Study:

• To compare the bottle-feeding skills of infants with CP±L using infant-driven feeding systems with those of healthy infants using standard bottles.
• To assess feeding proficiency, duration, milk transfer, and signs of feeding difficulty.

Main Methods:

• A cross-sectional cohort study was conducted at a large pediatric academic medical center.
• Participants included 15 infants with CP±L using the Dr. Brown's Specialty Feeding System and 15 typically developing infants using standard Dr. Brown's bottles.
• Key outcome measures were bottle-feeding proficiency, duration, milk transfer, and feeding difficulties.

Main Results:

• Feeding proficiency in five minutes was significantly lower for infants with CP±L (15-21%) compared to controls (44%).
• Milk transfer was lower in the CP±L group (75%) versus controls (96%), with a significantly lower milk transfer rate (3-5 mL/min vs. 9 mL/min).
• Feeding duration was longer for infants with CP±L (29-32 minutes) than for controls (13 minutes), and coughing was more frequent in the CP±L group (40% vs. 27%).

Conclusions:

• Infants with CP±L demonstrate distinct feeding patterns compared to noncleft infants, characterized by reduced proficiency and intake.
• Even with specialized feeding systems, infants with CP±L require careful management to optimize feeding outcomes.
• Further research may explore long-term feeding development and intervention strategies for this population.