Promoting Breast Milk Nutrition in Infants With Cleft Lip and/or Palate.
BACKGROUND
The orofacial defect of cleft lip/palate (CL/P) involves an altered physiological anatomy that affects the infant's feeding ability. Infants have cleft lip (CL), cleft palate (CP), or both (CL/P). Dysfunction in the seal, as with cleft lip, or in the ability to coordinate muscle movement to generate negative pressure, as with cleft palate, leads to feeding issues that may compromise growth and affect bonding.


OBJECTIVE
The purpose of this article is to present (1) scientific evidence that supports clinical feeding practices for the infant with CL/P and (2) teaching strategies for staff and parents.


METHODS
Evidence was synthesized using a narrative review of randomized controlled trials, qualitative studies, systematic reviews, professional guidelines, and position statements. Findings were used to present specialized equipment and feeding techniques to support human milk feeding.


RESULTS
Special considerations for feeding infants with CL/P include assessing the infant's sucking ability, demonstrating proper breastfeeding positioning, supporting mothers to establish and maintain their milk supply, considering adaptive feeding equipment (ie, specialized bottles and nipples), and education about the benefits of human milk.


CONCLUSIONS
Support from healthcare professionals, particularly lactation specialists and nursing staff, is critical. Breastfeeding and the use of human milk should be prioritized and supported. Research is needed to explore environmental, genetic, and nutritional causes (eg, folic acid deficiency) of orofacial defects.
Banner University Medical Center (Ms Burca), College of Nursing, University of Arizona (Dr Gephart and Ms Miller), and St. Joseph's Medical Center (Ms Cote), Tucson, Arizona.
Nicole Diane L
ND
Burca
Sheila M
SM
Gephart
Connie
C
Miller
Catherine
C
Cote
D001942:Breast Feeding / Q000379:methods*; D002971:Cleft Lip; D002972:Cleft Palate; D005248:Feeding Methods / Q000451:nursing; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008895:Milk, Human