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The relation between clinically diagnosed and parent-reported feeding difficulties in children with and without
Iris A C de Vries1, Camille H A L Guillaume2,3, Wouter M Penris4
1Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre, PO Box 85500, 3508 GA, Utrecht, the Netherlands. iacdevries@live.nl.
Insights
Feeding difficulties in infants with cleft lip and/or palate (CL/P) require timely diagnosis. Combining parental insights with professional oral motor assessments improves identification and referral for children with CL/P.
Area of Science:
- Craniofacial Malformations
- Pediatric Feeding Disorders
- Healthcare Diagnostics
Background:
- Cleft lip and/or palate (CL/P) affects 1 in 600-1000 newborns globally, frequently causing feeding difficulties (25-73%).
- Delayed diagnosis and referral for CL/P feeding issues can lead to serious complications, impacting growth and development.
- Current diagnostic methods for CL/P feeding difficulties are challenging, highlighting the need for improved screening and objective parental reporting.
Purpose of the Study:
- To investigate the correlation between parental perspectives and standardized professional observations of feeding difficulties in children with and without CL/P.
- To compare parent-reported feeding issues with objective oral motor assessments in 60 infants at 17 months.
- To evaluate the utility of the Montreal Children's Hospital Feeding Scale (MCH-FSD) against the Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA).
Main Methods:
- Cross-sectional study involving 60 children aged 17 months, with and without clefts.
- Utilized the validated Dutch version of the Montreal Children's Hospital Feeding Scale (MCH-FSD) for parental perception.
- Employed the Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA) for professional oral motor skill evaluation.
Main Results:
- Parents of children with CL/P reported fewer feeding problems than expected on average.
- Oral motor skills in spoon feeding were significantly associated with oral motor skills for solid food intake in CL/P patients.
- The severity and extent of the cleft positively correlated with the incidence of feeding difficulties.
Conclusions:
- Timely diagnosis and referral are crucial for managing feeding difficulties in children with CL/P.
- Integrating parental observations with healthcare professionals' oral motor assessments enhances diagnostic accuracy.
- This combined approach is vital for effective early intervention and management of feeding challenges in infants with CL/P.
Abstract:
A cleft lip and/or palate (CL/P) is one of the most common craniofacial malformations, occurring worldwide in about one in 600-1000 newborn infants. CL/P is known to influence the feeding process negatively, causing feeding difficulties in 25-73% of all children with CL/P. Because there is a risk for serious complications in these children regarding feeding difficulties, there is often a need for intensive medical counseling and treatment. At this moment, adequate diagnosis and measurement remain a challenge and often lead to a delayed referral for professional help. Since parents play a big part in reporting feeding difficulties, it is important to help objectify parents' experiences, as well as the use of a frontline screening instrument for routine check-ups during medical appointments. The aim of this study is to investigate the relationship between parent perspective and standardized observation by medical professionals on feeding difficulties in 60 children with and without clefts at the age of 17 months. We focus on the information from parents and health professionals by comparing the Observation List Spoon Feeding and the Schedule for Oral Motor Assessment with the validated Dutch translation of the Montreal Children's Hospital Feeding Scale. Conclusion: There is a need for timely and adequate diagnosis and referral when it comes to feeding difficulties in children with CL/P. This study underscores the importance of combining both parental observations and measurements of oral motor skills by healthcare professionals to enable this. What is Known: • Early identification of feeding difficulties can prevent adversely affected growth and development. • Clefts increase the probability of feeding difficulties; however, the diagnostic trajectory is unclear. • The Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA) are validated to measure oral motor skills. The Montreal Children's Hospital Feeding Scale Dutch version (MCH-FSD) has been validated for the parental perception of infant feeding difficulties. What is New: • Parents of children with CL/P experience relatively few feeding problems in their child on average. • Oral motor skills for spoon feeding are associated with oral motor skills for solid foods in children with CL/P. • The extent of the cleft is associated with experiencing more feeding difficulties in children with CL/P.
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