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Early repair and breast-feeding for infants with cleft lip
Insights
Early cleft lip repair, especially within the first week of life, may reduce complications. Breast-feeding post-surgery also enhances weight gain and shortens hospital stays for infants.
Area of Science:
- Pediatric Surgery
- Neonatal Care
Background:
- Cleft lip repair is a common surgical procedure in newborns.
- Optimizing surgical timing and post-operative feeding methods can improve outcomes.
Purpose of the Study:
- To evaluate the impact of early cleft lip repair on surgical outcomes.
- To assess the effect of breast-feeding on post-operative recovery in infants with cleft lip.
Main Methods:
- Retrospective analysis of 100 cleft lip repairs categorized by age at operation.
- Evaluation of a subgroup of 26 infants operated on within the first week of life.
- Prospective assessment of 60 mothers regarding post-operative feeding methods (breast-feeding, cup/syringe, bottle).
Main Results:
- No significant difference in complication rates between early (first 3 weeks) and later cleft lip repair.
- Infants repaired within the first week of life showed significantly fewer complications (8%).
- Breast-feeding was associated with enhanced weight gain and a 33% reduction in hospital stay compared to cup feeding.
Conclusions:
- Early cleft lip repair, particularly within the first week, is associated with reduced complications.
- Breast-feeding following cleft lip surgery promotes better weight gain and shorter hospitalizations.
- Current management recommendations encourage early repair and breast-feeding for optimal outcomes in newborns with cleft lip.
Abstract:
This study attempts to define the effect of early repair and breast-feeding on the outcome of cleft lip surgery. The first part deals with 100 consecutive cleft lip repairs categorized retrospectively by age at operation. Forty-nine patients were operated on during the first 3 weeks of life; 51 at an older age. There were no statistically significant differences in complication rate between the groups (14 and 18 percent, respectively). A subgroup of 26 infants was operated on at a week or less of age; these sustained significantly fewer complications (8 percent). There was no apparent difference in the operative results as defined by whether or not the child needed a subsequent revision. A second group of 60 mothers was offered the choice of breast-feeding their babies immediately following operation. Sixteen breast-fed for a minimum of 6 weeks, 22 were fed by means of a cup or syringe, and 22 started breast-feeding but converted to a bottle within 6 weeks. No complications attributable to breastfeeding were observed, and the rate of weight gain was definitely enhanced in the breast-feeding group. Hospital stay was shortened by an average of over a day (33 percent) as compared with those fed by cup. This effect was related to the easier transition from IV administration to oral intake when breast-fed. We are currently encouraging early repair and breast-feeding in the full-term baby as the optimum method of management of newborns with cleft lip.