Feeding interventions among cleft lip/palate infants: A systematic review and meta-synthesis

Abstract

Cleft lip and palate (CLP) affect about one baby of every 700 newborn due to alterations in the normal development of the primary and/or secondary palate. The prevalence of clefts in India is between 27,000 and 33,000/year. Searches were undertaken in PubMed, Cochrane database, Web of Science, Scopus, and Google Scholar databases, for primary research studies that report on feeding interventions/feeding techniques/feeding methods, challenges faced by mother/care taker/health personnel as they include most of the publications in this area. Papers were independently reviewed by two authors and Thomas et al's assessment criteria checklist (2003) was used to assess the methodological quality. This systematic review was registered in PROSPERO under number CRD42020208437. The review included 25 studies: 21 quantitative, 2 qualitative, and two mixed methods study, involving 1564 infants and children (age ranging from 1 week to 5 years old) and 790 mothers of Infants with CLP from 13 countries. While comparing the efficacy of the three feeding techniques such as paladai fed, bottle fed, and spoon fed in improving the weight gain pattern the result showed mean weight gain among paladai feeding was better than the bottle or spoon-feeding. Common feeding problems observed were nasal regurgitation, vomiting, and choking, etc. Infants with cleft palate had some major challenges such as aspiration, choking, and inadequate growth. Beyond the esthetic and psychologic implications of the presence of orofacial clefts, the feeding of the child is usually the next concern of the parents and caregivers, a factor which can result in considerable stress to the mother. A prompt diagnosis, especially of a CP, and visit by the cleft team immediately after the birth so that the family can be supported and taught the skills of feeding, is essential.