Abstract
There is limited description of the feeding characteristics of infants with unrepaired cleft lip and palate, exposed to HIV, but not necessarily infected. To compare the feeding characteristics of infants with unrepaired cleft lip and palate and HIV-exposure, to infants with unrepaired cleft lip and palate only. A two-group comparative design with a validated measure, the Neonatal Feeding Assessment Scale was used. The effectiveness of oral feeding skills were included as objective measure. Twelve participants with unrepaired cleft lip and palate and HIV-exposure and 13 with unrepaired cleft lip and palate were matched according to cleft type and use of feeding obturator. There were no differences between the groups for mean age, birth weight and gestation. Participants were between two and 89 days old, bottle fed, and had no syndrome/co-occurring disorder. Nine (75%) participants in the research group and only two (15.38%) in the control grouppresented with the likelihood of oropharyngeal dysphagia. Apart from feeding difficulties as a result of structural impairment, the research group showed symptoms of neurological involvement. The research group presented with distinctive symptoms of oropharyngeal dysphagia. More studies using different measuring tools are required to strengthen the evidence.
Highlights
Prior to the availability of anti-retroviral treatment (ART), infants born from HIV-positive mothers were infectedAfrican Health Sciences infants should receive dual prophylaxis with daily Zidovudine (ZDV) and Nevirapine (NVP) for the first six weeks of life, whether breastfed or formula fed, and a 12-week extended use of NVP alone or dual treatment (ZDV/NVP), to ensure prevention of mother-to-child-transmission (PMTCT) during breastfeeding[5]
oropharyngeal dysphagia (OPD) was expected in both groups as they all have an unrepaired cleft lip and palate (CLP), more participants in the Research Group (RG) presented with OPD compared to the Control Group (CG)
In comparison with the few CG participants identified with OPD, the RG presented with unique symptoms of OPD and difficulties with oral feeding skills (OFS)
Summary
Prior to the availability of anti-retroviral treatment (ART), infants born from HIV-positive mothers were infectedAfrican Health Sciences infants should receive dual prophylaxis with daily Zidovudine (ZDV) and Nevirapine (NVP) for the first six weeks of life, whether breastfed or formula fed, and a 12-week extended use of NVP alone or dual treatment (ZDV/NVP), to ensure PMTCT during breastfeeding[5]. Prenatal exposure to any form of ART has not yet been linked to cleft lip and palate (CLP), infants born with the condition may have been exposed to a double teratogenic effect, which includes the HI-virus and ART medication[11]. As two separate groups, feeding difficulties of infants with unrepaired CLP, and infants with HIV infection are described in great detail in the literature. There appears to be no reports on feeding characteristics of infants with unrepaired CLP and HIV-E, receiving ART. There is limited description of the feeding characteristics of infants with unrepaired cleft lip and palate, exposed to HIV, but not necessarily infected. Feeding difficulties in infants with unrepaired cleft lip and palate and HIV-exposure.
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