Abstract
We performed a questionnaire survey regarding inter-disciplinary care teams and breastfeeding guidance for mothers of babies with cleft lip and/or palate. Responses were obtained from a total of 130 medical facilities performing surgery for cleft lip and palate and registered by the Japanese Cleft Palate Association. The following findings were obtained:
1. Approximately half of the facilities answered that less than 10% of mothers of babies with cleft lip and palate did not practice direct breastfeeding at the initial visit to the facility. However, approximately 30% of facilities failed to provide information on whether direct breastfeeding for the babies was performed.
2. Most facilities provided lactation guidance for mothers of babies with cleft lip and/or palate. However, about half of the facilities focused solely on methods of bottle feeding, such as how to select artificial nipples and how to use nipples for babies with cleft palate. Guidance on breastfeeding was given at 48% of facilities.
3. The nipple type most commonly recommended for mothers who experienced difficulty bottle feeding using usual nipples was the P-type nipple (72%), followed by the NUK type (39%) and the Chuchu type (34%).
4. After plastic surgery, 35% of mothers did not change their bottle feeding method from that used before the operation. In other cases, narrow-mouthed bottles, nutrition tubes, or spoons were used in order to allow the wound to heal normally.
5. A total of 82% of facilities answered that direct breastfeeding for babies with cleft lip and/or palate is feasible depending on the mother's situation, and 57% of facilities answered that assistance for mothers is necessary for the establishment of direct breastfeeding.
6. Important interventions for promoting direct breastfeeding for babies with cleft lip and palate included “advice from treatment team from immediately after birth” (64%) and “enhancing knowledge of breastfeeding guidance among obstetric staff” (48%); however, only 21% of facilities cooperated with maternity hospitals to implement these measures. Additional measures included “improvement of palatal plate” for direct breastfeeding (48%) and “improvement of artificial nipples” (33%).
