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Semin Speech Lang 2011; 32(2): 115-126
DOI: 10.1055/s-0031-1277714
© Thieme Medical Publishers

Feeding Issues and Interventions in Infants and Children with Clefts and Craniofacial Syndromes

Claire K. Miller1
  • 1Speech Pathologist III and Program Director, Aerodigestive and Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Publication History

Publication Date:
26 September 2011 (online)

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ABSTRACT

Problems with oral feeding occur in varying degrees in infants born with cleft lip/palate and/or craniofacial syndromes. The extent of clefting is associated with the severity of feeding problems, and if cleft lip/palate occurs in conjunction with a craniofacial syndrome, additional structural, airway, and neuromotor issues may be present. The infant's feeding and swallowing skills may be significantly impaired, characterized by inefficient oral feeding skills coupled with poor airway protection ability during swallowing. Inadequate airway protection during swallowing has serious implications for the infant's respiratory health as sequelae of chronic aspiration during feeding may include recurrent respiratory illness, pneumonia, and lung damage. Feeding difficulty in nonsyndromic and syndromic cleft lip/palate infants has been documented as source of considerable stress for parents and can have a potential negative effect on the parent-infant bonding process. Therefore, timely identification of feeding problems by the speech pathologist with subsequent intervention and modification in the feeding method is essential, along with provision of early feeding instruction to families. The objective of this article is to review expert opinion and available evidence regarding factors that influence feeding success and efficiency in infants with nonsyndromic and syndromic cleft lip/palate. The types of compensatory strategies or interventions that are effective in alleviation of feeding and swallowing difficulties will be described. Descriptive reports, expert opinion, and available evidence from clinical trials to support the use of feeding interventions in treatment are reviewed.

KEYWORDS

Pediatric - craniofacial - feeding - swallowing - dysphagia

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Claire K MillerPh.D. 

Aerodigestive and Sleep Center, Cincinnati Children's Hospital Medical Center

MLC 4011, 3333 Burnet Avenue, Cincinnati, OH 45229-3039

Email: Claire.miller@cchmc.org

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