A longitudinal comparison of the psychological impact on mothers of neonatal and 3 month repair of cleft lip

Purpose: This study investigates whether the timing after birth of babies' cleft repairs influences the psychological status of mothers. Methods. Mothers of infants born with a cleft lip completed psychological a ssessments and semistructured interviews at four time points: 2-3 weeks, 3 months and 6 months following the birth. In addition, a preoperative assess ment and interview was completed within the first week of birth for those w ith infants undergoing neonatal repair and within the week before surgery f or the 3 month repair group. Results: There were no significant differences between mothers of infants w ith early (neonatal) and late (3 month) repairs on the emotional measures a t any time point or preoperatively. Means of measures for anxiety and depre ssive symptoms and the Impact of Event Scale were within the normal range. Measures of interaction with the infant, perceived infant difficulty, bondi ng and parental competence failed to show any impact of timing of operation . Women's emotional status improved significantly over the 6 month period r egardless of operation timing. Qualitative analysis of interview data indic ated most mothers preferred their infant to receive neonatal repair. Conclusions: There was no evidence to support the idea that repair neonatal ly or at 3 months led to differential levels of anxiety or depressive sympt oms or differences in attachment to the infant. Nevertheless mothers expres sed a preference for and greater satisfaction with neonatal repair. In the absence of definitive evidence of differences in physical outcome, parental preferences should routinely be considered in deciding the timing of this procedure.