title: Feeding methods for children with cleft lip and/or palate: a systematic review.
abstract: BACKGROUND
  Feeding difficulties in children with cleft lip and palate (CLP) are frequent and appear at birth due to impairment of sucking and swallowing functions. The use of appropriate feeding methods for the different types of cleft and the period of the child's life is of utmost importance for their full development.
  
  
  OBJECTIVE
  Review studies comparing feeding methods for children with CLP, pre- and postoperatively.
  
  
  METHODS
  The search covered the period between January 1990 and August 2015 in the PubMed, LILACS, SciELO, and Google Scholar databases using the terms: cleft lip or cleft palate and feeding methods or breastfeeding or swallowing disorders and their synonyms. This systematic review was recorded in PROSPERO under number CRD42014015011. Publications that compared feeding methods and published in Portuguese, English, and Spanish were included in the review. Studies with associated syndromes, orthopedic methods, or comparing surgical techniques were not included.
  
  
  RESULTS
  The three reviewed studies on the period prior to surgical repair showed better feeding performance with three different methods: squeezable bottle, syringe, and paladai bottle. Only one study addressed the postoperative period of cleft lip and/or palate repair, with positive results for the feeding method with suction. Likewise, the post-lip repair studies showed better results with suction methods. After palatoplasty, two studies showed better performance with alternative feeding routes, one study with suction method, and one study that compared methods with no suction showed better results with spoon.
  
  
  CONCLUSIONS
  The studies show that prior to surgical repair, the use of alternative methods can be beneficial. In the postoperative period following lip repair, methods with suction are more beneficial. However, in the postoperative period of palatoplasty, there are divergences of opinion regarding the most appropriate feeding methods.
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-graduação em Ciências da Reabilitação - Linha Musculoesquelética, Porto Alegre, RS, Brazil. Electronic address: duarte.giesse@gmail.com.
authors.forename: Giesse Albeche
authors.initials: GA
authors.lastname: Duarte
authors.affiliation: Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Ramon Bossardi
authors.initials: RB
authors.lastname: Ramos
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-graduação em Ciências da Reabilitação - Linha Musculoesquelética, Porto Alegre, RS, Brazil.
authors.forename: Maria Cristina de Almeida Freitas
authors.initials: MC
authors.lastname: Cardoso
mesh_terms: D002648:Child; D002971:Cleft Lip; D002972:Cleft Palate; D005248:Feeding Methods; D006801:Humans
keywords: Aleitamento materno; Breastfeeding; Cleft lip; Cleft palate; Feeding methods; Fenda labial; Fissura palatina; Métodos de alimentação; Swallowing disorders; Transtornos de deglutição