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唇裂、腭裂或唇腭裂婴儿生长发育的喂养干预措施。

Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate.

作者信息

Glenny A M, Hooper L, Shaw W C, Reilly S, Kasem S, Reid J

机构信息

Cochrane Oral Health Group, MANDEC, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH.

出版信息

Cochrane Database Syst Rev. 2004(3):CD003315. doi: 10.1002/14651858.CD003315.pub2.


DOI:10.1002/14651858.CD003315.pub2
PMID:15266479
Abstract

BACKGROUND: Cleft lip and cleft palate are common birth defects, affecting about one baby of every 700 born. Feeding these babies is an immediate concern and there is evidence of delay in growth of children with a cleft as compared to those without clefting. In an effort to combat reduced weight for height, a variety of advice and devices are recommended to aid feeding of babies with clefts. OBJECTIVES: This review aims to assess the effects of these feeding interventions in babies with cleft lip and/or palate on growth, development and parental satisfaction. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials register (June 2001), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2004), MEDLINE (1966 to May 24th 2004), EMBASE (1980 to August 7th 2002), CINAHL (1982 to August 7th 2002), PsychINFO (1967 to August 13th 2002), AMED (1985 to August 13th 2002). Attempts were made to identify both unpublished and ongoing studies. There was no restriction with regard to language of publication. SELECTION CRITERIA: Studies were included if they were randomised controlled trials (RCTs) of feeding interventions for babies born with cleft lip, cleft palate or cleft lip and palate up to the age of 6 months (from term). DATA COLLECTION AND ANALYSIS: Studies were assessed for relevance independently and in duplicate. All studies meeting the inclusion criteria were data extracted and assessed for validity independently by each member of the review team. Authors were contacted for clarification or missing information whenever possible. MAIN RESULTS: Four RCTs with a total of 232 babies, were included in the review. Comparisons made within the RCTs were squeezable versus rigid feeding bottles (two studies), breastfeeding versus spoon-feeding (one study) and maxillary plate versus no plate (one study). No statistically significant differences were shown for any of the primary outcomes when comparing bottle types, although squeezable bottles were less likely to require modification. No statistically significant difference was shown for infants fitted with a maxillary plate compared to no plate. A statistically significant difference in weight (kg) at 6 weeks post-surgery was shown in favour of breastfeeding when compared to spoon-feeding (mean difference 0.47; 95% CI: 0.20, 0.74). REVIEWERS' CONCLUSIONS: Squeezable bottles appear easier to use than rigid feeding bottles for babies born with clefts of the lip and/or palate, however, there is no evidence of a difference in growth outcomes between the bottle types. There is weak evidence that babies should be breastfed rather than spoon-fed following surgery for cleft lip. No evidence was found to assess the use of any types of maternal advice and/or support for these babies.

摘要

背景:唇腭裂是常见的出生缺陷,每700个出生婴儿中约有1个受影响。喂养这些婴儿是当务之急,有证据表明,与非唇腭裂儿童相比,唇腭裂儿童生长发育迟缓。为了应对身高体重降低的问题,人们推荐了各种建议和装置来帮助喂养唇腭裂婴儿。 目的:本综述旨在评估这些喂养干预措施对唇腭裂婴儿生长发育及家长满意度的影响。 检索策略:我们检索了Cochrane口腔健康组试验注册库(2001年6月)、Cochrane对照试验中心注册库(CENTRAL)(Cochrane图书馆,2004年第2期)、MEDLINE(1966年至2004年5月24日)、EMBASE(1980年至2002年8月7日)、CINAHL(1982年至2002年8月7日)、PsychINFO(1967年至2002年8月13日)、AMED(1985年至2002年8月13日)。试图识别未发表和正在进行的研究。对发表语言没有限制。 入选标准:纳入的研究需为针对出生至6个月(足月起)的唇裂、腭裂或唇腭裂婴儿喂养干预的随机对照试验(RCT)。 数据收集与分析:研究由两人独立评估相关性。所有符合纳入标准的研究均进行数据提取,由综述团队的每位成员独立评估其有效性。如有可能,会联系作者进行澄清或获取缺失信息。 主要结果:本综述纳入了4项RCT,共232名婴儿。RCT内的比较包括可挤压奶瓶与硬奶瓶(两项研究)、母乳喂养与匙喂(一项研究)以及上颌板与无板(一项研究)。比较奶瓶类型时,任何主要结局均未显示出统计学显著差异,不过可挤压奶瓶不太可能需要改装。与无板相比,佩戴上颌板的婴儿未显示出统计学显著差异。与匙喂相比,母乳喂养在术后6周时体重(kg)有统计学显著差异(平均差值0.47;95%可信区间:0.20,0.74)。 综述作者结论:对于唇裂和/或腭裂婴儿,可挤压奶瓶似乎比硬奶瓶更易于使用,然而,没有证据表明两种奶瓶类型在生长结局上存在差异。有微弱证据表明唇裂手术后婴儿应进行母乳喂养而非匙喂。未发现评估针对这些婴儿的任何类型母亲建议和/或支持措施使用情况的证据。

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引用本文的文献

[1]
Prevalence of feeding disorders in children with cleft palate only: a retrospective study.

Clin Oral Investig. 2014

[2]
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