Reid Julie, Kilpatrick Nicky, Reilly Sheena
Murdoch Children's Research Institute and Speech Pathology Department, Royal Children's Hospital, Flemington Road, Parkville 3052, Victoria, Australia.
Cleft Palate Craniofac J. 2006 Nov;43(6):702-9. doi: 10.1597/05-172.
To examine the natural history of feeding skills in babies with clefts and identify risk factors and predictors of poor feeding.
Sixty-two babies with clefts were examined at 2 weeks, 3 months, and 14 months of age.
Feeding ability, oral motor function, and feeding efficiency were assessed. Univariate analyses were used to determine whether oral motor function and sequelae varied according to feeding ability or cleft condition. Multivariable logistic regressions were used to determine risk factors for poor feeding.
Poor feeding skills were detected in one third of newborns. The prevalence of poor feeding reduced to 19% at 3 months of age and 15% at 14 months of age. Oral motor dysfunction and sequelae (particularly nasal regurgitation) were more commonly observed in babies with poor feeding skills irrespective of comorbidity. The main risk factor for poor feeding was a diagnosis of syndrome or Pierre Robin sequence (PRS). At 2 weeks of age, babies with syndrome or PRS were 15 times more likely to have poor feeding skills than their nonsyndromic counterparts. When syndrome or PRS was controlled for, babies with cleft palate and cleft lip and palate were equally likely to have poor feeding skills. Parental report of feeding efficiency was predictive of poor feeding in young babies.
Poor feeding skills are relatively common in newborns with cleft palate and cleft lip and palate. Treatment for feeding problems may be needed beyond the first year of life, especially for babies born with PRS or a syndrome.
研究腭裂患儿喂养技能的自然发展历程，确定喂养困难的风险因素及预测指标。
62名腭裂患儿分别在2周、3个月和14个月时接受检查。
评估喂养能力、口腔运动功能和喂养效率。采用单因素分析确定口腔运动功能及后遗症是否因喂养能力或腭裂情况而异。采用多变量逻辑回归确定喂养困难的风险因素。
三分之一的新生儿存在喂养技能欠佳的情况。3个月大时，喂养困难的发生率降至19%，14个月大时降至15%。无论是否合并其他疾病，喂养技能欠佳的婴儿更常出现口腔运动功能障碍及后遗症（尤其是鼻反流）。喂养困难的主要风险因素是综合征或皮埃尔·罗宾序列（PRS）的诊断。在2周龄时，患有综合征或PRS的婴儿出现喂养技能欠佳的可能性是非综合征婴儿的15倍。在控制综合征或PRS因素后，单纯腭裂和唇腭裂患儿出现喂养技能欠佳的可能性相同。父母对喂养效率的报告可预测婴儿早期的喂养困难情况。
腭裂和唇腭裂新生儿中喂养技能欠佳相对常见。可能需要在出生后第一年之后对喂养问题进行治疗，尤其是对于患有PRS或综合征的婴儿。
