Infant-Driven Feeding Systems: Do They "Normalize" the Feeding Experience of Infants With Cleft Palate?

Objective: To examine feeding skills of infants with cleft palate with or without cleft lip (CP±L) using infant-driven feeding systems compared to healthy controls on standard bottles.

Design: Cross-sectional cohort.

Setting: Large pediatric academic medical center in the Midwestern United States.

Participants: Infants with CP±L (n = 15) using the Dr. Brown's Specialty Feeding System and typically developing infants without CP±L (n = 15) using the Dr. Brown's Natural Flow Original or Options bottles.

Main Outcome Measure(s): Bottle-feeding proficiency, duration, milk transfer, and signs of feeding difficulty.

Results: Five-minute feeding proficiency differed significantly between groups with the control group taking 44% of the feed compared to 15% for the CP±L group on level 1 ( < .001) and 21% on level 2 ( < .001) nipples. Proportion of milk transfer was 96% ± 7% for controls and 75% ± 24% for the CP±L group ( = .013). Feeding duration (minutes) differed between the control group (13 ± 3) and the CP±L groups on each nipple level (level 1: 29 ± 16; = .003; level 2: 32 ± 11; = .001). Milk transfer rate (mL/min) was 9 ± 3 for control infants compared to 3 ± 1 for infants with CP±L on level 1 ( < .001) and 5 ± 1 on level 2 ( = .007). Coughing occurred in 40% of infants with CP±L and 27% of controls.

Conclusions: Even when using specialty bottles, infants with CP±L differ from noncleft infants in feeding proficiency, duration, and overall intake.