New research on oral clefts

26 May 2017
Volume 31 · Issue 6

Breast-feeding is a common struggle for children born with a cleft palate. Because of this issue, it is important to differentiate between ‘breast-feeding’ and ‘breast milk feeding’, or the delivery of breast milk to the baby via other means.

A recent study by doctors at a New York craniofacial medical centre suggest more focus should be placed not on how children with oral clefts are fed, but rather on what they are fed.

An article published in the current issue of The Cleft Palate–Craniofacial Journal reports on how often patients with oral clefts were fed breast milk. Instead of evaluating how many infants with clefts were feeding at their mother’s breast, the researchers assessed the rates at which these patients were being given breast milk, regardless of delivery method. In addition to ideal nutrient content and composition, breast milk also contains both immune cells and antibodies from the mother, which greatly help the newborn infant defend against pathogens. Due to the variety of medical benefits found in breast milk, the World Health Organization recommends six months of exclusive breast-feeding.

The researchers interviewed the parents of 110 children who were born with an oral cleft and treated at New York University Langone Medical Center. Hoping to discover the amount of breast milk that patients received despite having a cleft palate, they asked about the child’s feeding habits and about counselling related to feeding the child breast milk. Considering patients with a cleft lip only are more successful at breast-feeding, the researchers focused on patients with cleft palates.

Approximately 67 percent of patients received breast milk for some period of time, with the average duration being 5.3 months. When used, breast milk made up 75 per cent or more of total diet, and the researchers found that infants with cleft palates were far more likely to receive breast milk if their parents received feeding-related counselling. Among those parents interviewed, 84 percent received information about feeding breast milk to their child. About 75 percent of patients with oral clefts received breast milk via a Haberman feeder, a specially designed bottle for infants who have sucking difficulties, with another 11 percent utilising an alternative type of specialty bottle.

The study looked at a 13-year period and found that the more recent the birth, the greater the likelihood of receiving breast milk. These rates mirrored national trends of feeding children breast milk.

North American children without a cleft, and even those with an isolated cleft lip, remain more likely to be fed breast milk than those with a cleft palate. However, the researchers concluded that previous reports underestimated how many infants with clefts are receiving breast milk. Their research also showed that children with clefts are given breast milk in larger quantities and for a longer period than previously reported.

Full text of the article, “Breast Milk Feeding Rates in Patients With Cleft Lip and Palate at a North American Craniofacial Center,” The Cleft Palate–Craniofacial Journal, Vol. 54, No. 3, 2017, is available at www.cpcjournal.org/doi/full/10.1597/15-241