EFFECTIVENESS OF 2 FEEDING METHODS IN IMPROVING ENERGY-INTAKE AND GROWTH OF INFANTS WITH CLEFT-PALATE - A RANDOMIZED STUDY

Objective To compare two feeding methods advocated for infants with cl eft palate: (a) a squeezable plastic container with a narrow, long cro sscut nipple (squeezable cleft palate nurser); and (b) a standard nipp le with a crosscut (crosscut nipple). The effectiveness of a nutrition intervention protocol for these infants was also documented. Design T hirty-one infants (median age=15 days) were randomized to one of two f eeding methods (18 infants, squeezable cleft lip/palate nurser; 13 inf ants, crosscut nipple) within sex (21 boys, 10 girls) and palatal defe ct (22 cleft lip and palate, 9 isolated cleft palate) categories. The intervention included feeding technique instructions, nutrition counse ling at each clinic visit, use of the same 20 kcal/oz standard formula for 12 months, and introduction of infant and soft table foods at 6 m onths. Four-day food records and growth data were obtained. Main outco me measures Mean energy and protein intakes at 3 and 6 months of age a nd growth measurements during the first 18 months of life were obtaine d. Statistical analyses A repeated measures analysis of variance for i ntakes was performed with time as the repeated measure and feeding met hod as the covariable. Similar analyses were completed for growth meas ures with sex and feeding method as covariates. Results Mean energy in take at 3 and 6 months of age (P=.24) and growth measurements during t he first 18 months of life (P values: weight gain [grams per day], .73 ; weight, .2 1; length, .07; head circumference, .18; triceps and subs capular skinfolds and mid-arm circumference, .47,.48, and .69, respect ively) were not significantly different. Both feeding methods were eff ective in supporting normal growth. Applications With adequate instruc tion related to the use of either feeding technique and close nutritio n follow-up early in infancy, a dietitian or other health care practit ioner may advise the use of either feeding method. These data support the need for feeding and nutrition education and early nutrition inter vention.