Post-operative feeding strategies for infants with cleft lip

Post-operative feeding techniques for infants following primary repair of cleft lip vary considerably. Recommendations range from immediate return to nipple feeding post-operatively to abstinence from nipple feeding for up to 6 weeks. Different surgeons prescribe different post-operative feeding protocols among and within centers. The purposes of this retrospective study (n = 42) were to: (1) identify the specific nonnipple feeding guidelines given to caregivers prior to surgery and the duration for those practices to be used in the post-operative period, (2) describe caregiver compliance, and (3) identify post-operative complications (e.g. dehiscence) related to type and duration of feeding strategies. Feeding guidelines included: nonnipple feeding for 6 weeks (n = 28, 67%), 3 weeks (n = 6, 14%), 2 weeks (n = 6, 14%), and unrestricted return to nipple (n = 2, 5%). Nearly all caregivers (n = 37, 88%) complied with recommendations. The others (n = 5, 12%) returned their infants to nipple feeding sooner than recommended (three in the nonnipple group for 6 weeks, and one each in the other two groups). No medical/surgical complications were related to feeding strategies.

caregivers typically comply with post-operative feeding recommendations. However, the variability in those recommendations should be reduced with feeding made as easy as possible and not a jeopardy to wound healing.