Non-Nutritive Suck and Parent Report of Feeding Skills in Infants Born With Cleft Lip and/or Palate

Abstract

Objective To compare non-nutritive sucking (NNS) and caregiver-reported feeding skills in infants with cleft lip and/or palate (CL/P) to a control group of typically developing infants without CL/P. To examine differences in NNS patterns and feeding behavior between cleft phenotypes. Design Prospective, cross-sectional study comparing infants born with CL/P to an age-matched control group with no congenital anomalies. Setting Urban, academic, tertiary care children's hospital and academic department of speech-language pathology. Patients, Participants Forty-two infants (21 with CL/P; 21 without CL/P), 6 months of age and younger were included. Infants with syndromes or who underwent cleft repair were excluded. Main Outcome Measures A 5min NNS sample was collected from the infant sucking on the lab's custom research pacifier. The infant's caregiver completed the Neonatal Eating Assessment Tool (NeoEAT) bottle-feeding section about their infant's feeding behaviors. Results Infants with CL/P demonstrated slower NNS frequency ( P = .04) and reduced suck amplitude ( P = .04) compared to the control group. Caregivers of infants with CL/P reported a higher incidence of gastrointestinal symptoms ( P = .04) and overall feeding difficulties ( P = .03) relative to the control group. There were no significant differences between CL/P phenotypes for NNS or caregiver reported outcomes. Conclusions Infants with CL/P demonstrate differences in NNS physiology and caregiver report measures of feeding compared to age-matched controls. These findings support the need for interventions to optimize sucking and feeding skill development in infants with CL/P.