title: The promotion of exclusive breastfeeding in infants with complete cleft lip and palate during the first 6 months after childbirth at Srinagarind Hospital, Khon Kaen Province, Thailand.
abstract: BACKGROUND
  Breastfeeding is especially important for infants with cleft lip and/or cleft palate because it helps prevent nasal septum irritation, decreases the number of ear infections, and provides a sort of psychologically support for the postpartum mothers. It is difficult for a baby born with a cleft lip and/or cleft palate to suck milk out of the breast or bottle.
  
  
  OBJECTIVE
  This study aimed to 1) promote exclusive breast-feeding in infants with CL-CP during their first 6 months after delivery and 2) examine risk factors related to the success of exclusive breastfeeding.
  
  
  METHODS
  A counseling session provided by a special trained nurse is arranged for the parents of these infants as the earliest after birth. The mothers were advised that the best breastfeeding position either cross cradle or football position. The mothers were instructed to support their breasts with four fingers underneath and press their thumb on top to squeeze breast milk to help the babies with CL-CP get enough milk. The breast squeezing should be related to baby's sucking, swallowing and breathing rhythm. The infant weight gain after birth, their comfort, 6-8 urine per day, and 1 - 2 stool per day were used as the indications of breastfeeding success.
  
  
  RESULTS
  Twenty infants were included in this study. A follow up after hospital discharge was set at 1 week 1, 2, 3, 4 and 6 months to provide continuously breastfeeding support for the mothers. After the 6-month period, we found that 2 infants were exclusively breastfed for 6 months and continued to have breast milk until 15 and 18 months of age, 2 infants had breastfeed for less than 2 months, and 16 infants for 3-4 months. Employment status played an important factor for the breastfeeding success among the mothers of CL-CP infants. The only 2 mothers able to provide 6 months exclusive breastfeeding did not work while the mothers who could not continue their breastfeeding reported that they felt very exhausted having to go to work and breastfeed their babies when they returned back home.
  
  
  CONCLUSIONS
  This study revealed that exclusive breastfeeding for CL-CP infants can be achieved when the relationship between infants, parents and their families were established.
authors.affiliation: Obstetrics and Gynecological Nursing Department, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Pornpen
authors.initials: P
authors.lastname: Pathumwiwatana
authors.forename: Suthida
authors.initials: S
authors.lastname: Tongsukho
authors.forename: Tarinee
authors.initials: T
authors.lastname: Naratippakorn
authors.forename: Suteera
authors.initials: S
authors.lastname: Pradubwong
authors.forename: Kusuma
authors.initials: K
authors.lastname: Chusilp
mesh_terms: D000818:Animals; D001942:Breast Feeding; D002971:Cleft Lip / Q000503:physiopathology*; D002972:Cleft Palate / Q000503:physiopathology*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education / Q000523:psychology; D049590:Postpartum Period; D012307:Risk Factors; D013391:Sucking Behavior / Q000502:physiology; D013785:Thailand