Penny Cameron, McGuire Connor, Bezuhly Michael
12361Dalhousie University, Halifax, Nova Scotia, Canada.
Cleft Palate Craniofac J. 2022 Dec;59(12):1527-1536. doi: 10.1177/10556656211051216. Epub 2021 Oct 29.
Various devices and techniques have been proposed to reduce feeding difficulties experienced by infants with cleft palate. The aim of this review is to identify and assess the scope and quality of evidence for these interventions.
A systematic review of published literature evaluating feeding interventions for infants with cleft palate (with or without cleft lip) from database inception to 2021 was conducted using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using a methodological index for nonrandomized studies, Cochrane, or a measurement tool to assess systematic reviews 2 instruments, according to study type.
Fourteen studies met inclusion criteria, with the majority (71%) of studies consisting of second-level evidence. Included interventions were specialty bottles (21%), alternative feeding delivery systems (14%), obturators (14%), and educational programs (14%). Specialty bottles and palatal obturators did not appear to offer any substantial growth advantages compared to traditional bottles or no intervention, respectively. Designated education programs for the mothers of infants with clefts had a positive impact on infant growth.
Overall evidence evaluating feeding interventions for infants with cleft palate was moderate to low. While it does not appear that specialized feeding delivery systems or palatal obturators significantly improve growth in infants with clefts compared to children without cleft conditions, education programs do appear to be beneficial.
已提出各种装置和技术来减少腭裂婴儿所经历的喂养困难。本综述的目的是识别和评估这些干预措施的证据范围和质量。
使用系统评价的首选报告项目指南,对从数据库建立到2021年发表的评估腭裂(伴或不伴唇裂)婴儿喂养干预措施的文献进行系统综述。根据研究类型,使用非随机研究的方法学指数、Cochrane或评估系统评价的测量工具2对纳入研究进行质量评估。
14项研究符合纳入标准,其中大多数研究(71%)包含二级证据。纳入的干预措施包括特殊奶瓶(21%)、替代喂养输送系统(14%)、阻塞器(14%)和教育项目(14%)。与传统奶瓶或不进行干预相比,特殊奶瓶和腭部阻塞器似乎分别没有提供任何显著的生长优势。为腭裂婴儿的母亲指定的教育项目对婴儿生长有积极影响。
评估腭裂婴儿喂养干预措施的总体证据为中等至低等。虽然与非腭裂儿童相比,特殊喂养输送系统或腭部阻塞器似乎并没有显著改善腭裂婴儿的生长,但教育项目似乎是有益的。