A Case of Feeding Function Therapy for a Child with Trisomy 13

Abstract

Children with trisomy 13 often have severe complications and difficulty with oral intake. We report a case in which oral sensory acceptance was good and oral intake was improved through feeding function therapy.

The patient was a 1-year-1-month-old girl who was referred to our department by a nearby dental clinic with the main complaints of poor progress in weaning and the need for a Hotz plate for cleft lip and palate surgery. She had a cleft lip and palate （CLP） and ventricular septal defect, and gross motor function was undetermined. She was fed infant formula using a feeding bottle for cleft lip and palate, and was eating early weaning food. Her baby teeth had not yet erupted, there was no hypersensitivity in the mouth, and oral sensory acceptance was good. She also accepted the Hotz plate well. When eating weaning food, tongue protrusion was observed, and food transport was difficult. We diagnosed her with adult swallowing failure, and the treatment plan was to continue infant formula and early weaning food and increase the amount of weaning food per meal. At 1 year and 10 months of age, the patient underwent surgery for lip reconstruction, soft palate reconstruction, and lingual frenectomy. The use of a Hotz plate was discontinued. At the age of 2 years, fluid intake training was instructed using jaw support. At the age of 3 years, the amount of baby food intake increased. Although acquisition of adult swallowing was insufficient, weak crushing and grinding movements were observed.

From the first consultation, oral sensory acceptance was good, and dental intervention improved feeding and swallowing function, such as maintaining oral intake and increasing the intake of baby food. In diseases in which progress of oral intake is difficult, earlier dental intervention may be able to promote oral sensory acceptance and improve feeding and swallowing function.