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Evaluation of a Digital Home Weight Monitoring Program for Infants With Cleft Palate
Thomas J Sitzman1,2,3, Kayla Tymous1, Megan Halvorson1
1Phoenix Children's Center for Cleft and Craniofacial Care a Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.
Insights
Digital home monitoring for infants with cleft palate did not reduce malnutrition rates but decreased speech-language pathology visits. The program identifies feeding issues but doesn't solve all malnutrition causes.
Area of Science:
- Pediatric care
- Medical technology
- Cleft lip and palate research
Background:
- Infants with cleft palate with or without cleft lip (CP±L) require careful monitoring for feeding and growth.
- Traditional monitoring involves frequent in-person clinic visits, which can be burdensome for families.
Purpose of the Study:
- To evaluate the effectiveness of a digital home monitoring program for infants with CP±L.
- To compare this program against traditional in-person clinic visit monitoring.
Main Methods:
- A retrospective cohort study was conducted at a metropolitan pediatric hospital.
- 88 infants with CP±L were analyzed: 41 in the digital home monitoring group and 47 in the traditional in-person visit group.
- Digital monitoring involved weekly caregiver submission of infant weights and feeding evaluations via a secure website.
Main Results:
- No significant difference in the incidence of malnutrition at 4 months of age between the two groups (13% vs 17%).
- Infants in the digital home monitoring program had significantly fewer in-person speech-language pathology visits (3.9 vs 5.4).
- Malnutrition was associated with Child Protective Services involvement and the presence of a syndrome.
Conclusions:
- Digital home monitoring for infants with CP±L did not reduce malnutrition incidence.
- The program effectively reduced the need for in-person speech-language pathology visits.
- While capable of identifying infants with feeding challenges, the program does not fully address multifactorial malnutrition contributors.
Abstract:
ObjectiveEvaluate the effectiveness of a digital home monitoring program for infants with cleft palate with or without cleft lip (CP ± L), compared to monitoring through in-person clinic visits.DesignRetrospective cohort study.SettingOne metropolitan pediatric hospital.PatientsEight-eight infants with CP ± L: 41 infants received digital home monitoring and 47 infants were monitored solely through in-person visits.InterventionsBeginning in September 2022, all infants with CP ± L were enrolled in a digital home monitoring program, in which caregivers weighed their child weekly at home and submitted those weights, along with subjective evaluations of their child's feeding, using a secure website. Submissions were monitored by the cleft team nurse coordinator.Main Outcome MeasuresThe primary outcome was the incidence of malnutrition at 4 months of age. The secondary outcome was the average number of in-person clinic visits during the first 4 months of life.ResultsThere was not a significant difference (P = .764) in the incidence of malnutrition between infants monitored in-person compared to infants in the home monitoring program (13% vs 17%). Infants in the home monitoring program had fewer in-person visits with speech-language pathology (5.4 vs 3.9; P < .001). Across groups, malnutrition was associated with Child Protective Services involvement (P = .001) and presence of a syndrome (P = .014).ConclusionsThe digital home monitoring program did not decrease the incidence of malnutrition, but it did reduce the number of speech-language pathology in-person visits. The program appears to distinguish infants who are gaining weight appropriately from those with feeding challenges, but it does not fully address the multifactorial contributors to malnutrition.
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