Kaye Alison, Cattaneo Carol, Huff Helen M, Staggs Vincent S
Children's Mercy Kansas City, Kansas City, Missouri.
Adv Neonatal Care. 2019 Apr;19(2):127-137. doi: 10.1097/ANC.0000000000000551.
Despite the recognized importance of human milk (HM) use, breastfeeding is often discouraged for infants with cleft lip and/or palate because of their anatomical abnormalities. Poor weight gain may require formula for calorie supplementation. Stresses associated with caring for infants with cleft lip/palate may decrease rates of HM provision to these infants.
This study investigates the experiences of mothers of infants with cleft lip/palate (CL/P) to determine choices and factors associated with providing HM to their infants.
A retrospective telephone survey was administered to a cohort of mothers of infants with CL/P.
Fifty mothers agreed to participate in the survey. Most (78%) initiated use of HM for a median duration of 4 months, 32% provided HM for 6 months or more, and 79% exclusively expressed their HM. Poor supply was the most frequent challenge to providing HM and led to cessation in 46% of the mothers. Formula was used to supplement for poor supply or poor infant weight gain in 90% of the mothers. The best predictors of a mother's use of HM were child not in day care, genetic diagnosis, and gestational age at birth. Only 36% of mothers reported individual encouragement to provide HM, and 18% reported they were specifically discouraged from providing HM for their infants.
Although initiation rates were high, there are opportunities to improve support for mothers to increase duration of HM provision in children with CL/P.
This study establishes a baseline for future prospective studies looking at the impact of active encouragement and provision of lactation support within the cleft team setting.
尽管人们认识到使用母乳的重要性，但唇裂和/或腭裂婴儿由于其解剖结构异常，母乳喂养往往不被提倡。体重增加不佳可能需要使用配方奶补充热量。照顾唇裂/腭裂婴儿带来的压力可能会降低这些婴儿的母乳喂养率。
本研究调查唇裂/腭裂（CL/P）婴儿母亲的经历，以确定与给婴儿提供母乳相关的选择和因素。
对一组唇裂/腭裂婴儿的母亲进行了回顾性电话调查。
50位母亲同意参与调查。大多数（78%）开始使用母乳，中位持续时间为4个月，32%提供母乳达6个月或更长时间，79%完全挤出母乳。母乳供应不足是提供母乳最常见的挑战，46%的母亲因此停止母乳喂养。90%的母亲使用配方奶补充母乳供应不足或婴儿体重增加不佳的情况。母亲使用母乳的最佳预测因素是孩子不在日托机构、基因诊断和出生时的孕周。只有36%的母亲报告得到了提供母乳的个人鼓励，18%的母亲报告她们被特别劝阻不要为婴儿提供母乳。
尽管开始母乳喂养的比例较高，但仍有机会加强对母亲的支持，以增加唇裂/腭裂儿童母乳喂养的持续时间。
本研究为未来前瞻性研究建立了一个基线，这些研究将探讨在腭裂治疗团队环境中积极鼓励和提供哺乳支持的影响。
