Feeding Infants with Cleft Lip and/or Palate in Brazil: Suggestions to Improve Health Policy and Research

Abstract

Objective To verify feeding resources used prior to corrective surgery among cleft babies from Brazil and to discuss suggestions to improve common feeding problems around the world. Design Cross-sectional descriptive study conducted at eight medical centers. Participants A total of 215 parents or guardians of cleft children. Methods Interview based upon a prevalidated questionnaire. The chi-square test and comparison of means by analysis of variance were used; significance level adopted was 5% ( P < .05). Results Feeding guidelines were provided in the maternity unit to 53% of the families. Breastfeeding was encouraged among 80% of mothers, predominantly in the South ( P = .016). However, follow-up after maternity discharge was not appropriately carried out and failure to breast-feed occurred in 78% of families. The feeding tube was used in 21%. According to families, for those who used the ordinary nipple, it was considered the best option by the majority (29%). Conclusion Neonatal feeding in cleft babies is a global challenge. Reports about the difficulties encountered and successful experiences would be helpful to disseminate strategies and stimulate research directed at the large-scale applicability of neonatal feeding for cleft babies on public health. This study detected the need to increase professional training and emphasizes the need for public policies addressing neonatal referral to specialized care wherever possible. It also stimulates research into using an ordinary nipple as another resource for feeding cleft babies and suggests an international discussion about specific recommendations for humanized primary health care.