J Med Assoc Thai 2010; 93 (10):71

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The Promotion of Exclusive Breastfeeding in Infants with Complete Cleft Lip and Palate during the First 6 Months after Childbirth at Srinagarind Hospital, Khon Kaen Province, Thailand
Pathumwiwatana P Mail, Tongsukho S , Naratippakorn T , Pradubwong S , Chusilp K

Background: Breastfeeding is especially important for infants with cleft lip and/or cleft palate because it helps prevent nasal
septum irritation, decreases the number of ear infections, and provides a sort of psychologically support for the postpartum
mothers. It is difficult for a baby born with a cleft lip and/or cleft palate to suck milk out of the breast or bottle.

This study aimed to 1) promote exclusive breast-feeding in infants with CL-CP during their first 6 months after
delivery and 2) examine risk factors related to the success of exclusive breastfeeding.

Material and Method:
A counseling session provided by a special trained nurse is arranged for the parents of these infants
as the earliest after birth. The mothers were advised that the best breastfeeding position either cross cradle or football
position. The mothers were instructed to support their breasts with four fingers underneath and press their thumb on top to
squeeze breast milk to help the babies with CL-CP get enough milk. The breast squeezing should be related to baby’s sucking,
swallowing and breathing rhythm. The infant weight gain after birth, their comfort, 6-8 urine per day, and 1 - 2 stool per day
were used as the indications of breastfeeding success.

Results: Twenty infants were included in this study. A follow up after hospital discharge was set at 1 week 1, 2, 3, 4 and 6
months to provide continuously breastfeeding support for the mothers. After the 6-month period, we found that 2 infants were
exclusively breastfed for 6 months and continued to have breast milk until 15 and 18 months of age, 2 infants had breastfeed
for less than 2 months, and 16 infants for 3-4 months. Employment status played an important factor for the breastfeeding
success among the mothers of CL-CP infants. The only 2 mothers able to provide 6 months exclusive breastfeeding did not
work while the mothers who could not continue their breastfeeding reported that they felt very exhausted having to go to work
and breastfeed their babies when they returned back home.

Conclusion: This study revealed that exclusive breastfeeding for CL-CP infants can be achieved when the relationship
between infants, parents and their families were established.

Keywords: Exclusive Breastfeeding, Infants with Complete Cleft Lip and Palate

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