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Current Postoperative Feeding Practices Following Surgical Repairs for Infants With Cleft Palate
Jessica L Williams1,2, Katelyn J Kotlarek3
1Phoenix Children's Center for Cleft and Craniofacial Care, Phoenix, AZ.
Insights
Postoperative feeding after cleft lip and palate repair varies widely among surgeons, with no standardized guidelines. This study surveyed American Cleft Palate-Craniofacial Association members on current feeding practices for infants.
Area of Science:
- Craniofacial Surgery
- Pediatric Feeding Therapy
- Cleft Care Coordination
Background:
- Most surgeons use restrictive feeding protocols post-cleft lip and palate repair.
- Lack of standardized recommendations leads to variable practices among cleft teams.
- Current practices for infant feeding after cleft repair are not well-documented.
Purpose of the Study:
- To investigate current postoperative feeding practices for infants undergoing cleft palate repair.
- To identify variations in feeding recommendations among cleft care providers.
Main Methods:
- A 50-question survey was distributed to members of the American Cleft Palate-Craniofacial Association (ACPA).
- Survey included providers from North America serving on cleft palate teams.
- Sixty-four respondents met the inclusion criteria for analysis.
Main Results:
- Respondents recommended various feeding methods post-lip surgery, including cleft-adapted bottles (88%) and immediate return to preoperative feeding (69%).
- Post-palate surgery recommendations included cleft-adapted bottles (55%), spoon feeding (36%), and cup feeding (64%).
- Infants could resume suction feeding at 20 days and age-appropriate diets at 15 days post-palate surgery.
Conclusions:
- Significant variation exists in postoperative feeding guidelines following cleft lip and palate repairs.
- The study highlights the heterogeneity of feeding protocols used by cleft teams.
Background:
Nearly all surgeons have restrictive postoperative feeding protocols in place after primary cleft lip and cleft palate repairs. There are no standardized recommendations, potentially resulting in widely variable practices among cleft surgeons and teams. The purpose of this study was to examine current postoperative feeding practices for infants with cleft palate after lip and palate repairs.
Methods:
A survey of 50 questions was sent to members of the American Cleft Palate-Craniofacial Association (ACPA). Inclusion criteria included providers from North America that have either currently or previously served on a cleft palate team and reached the surgical question set within the survey.
Results:
Sixty-four respondents met inclusion criteria. The majority were in speech-language pathology (47%) or nursing (41%) disciplines, involved in feeding consultations frequently (84%), and working in an outpatient setting (69%). After lip surgery, respondents recommended cleft-adapted bottle feeding (88%), spoon feeding (9%), cup feeding (13%), and syringe/squeeze bottle feeding (23%). The majority of respondents (69%) indicated infants could return to their preoperative feeding modality immediately after lip surgery. After palate surgery, respondents recommended cleft-adapted bottle feeding (55%), typical bottle feeding (3%), spoon feeding (36%), cup feeding (64%), and syringe/squeeze bottle feeding (30%). Infants could use a feeding system that required suction at an average of 20 days postoperatively and return to an age-appropriate diet at an average of 15 days postoperatively.
Conclusions:
The present study describes the wide variation of postoperative feeding guidelines used by cleft teams after lip and palate repairs.
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