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Cleft Lip and Palate
Swallowing/Feeding Treatment

General Findings

 

 

External Scientific Evidence

  

Evidence-Based Practice Guidelines

Royal College of Speech & Language Therapists; Department of Health (UK); National Institute for Clinical Excellence (NICE) 
 
Royal College of Speech and Language Therapists Clinical Guidelines: 5.5 Cleft Palate & Velopharyngeal Abnormalities
Taylor-Goh, S., ed. (2005).
RCSLT Clinical Guidelines. Bicester, Speechmark Publishing Ltd.
 
Description
This guideline provides recommendations for the assessment and treatment of cleft palate and velopharyngeal abnormalities. The target audience for this guideline is speech-language pathologists. Recommendations are based on randomized controlled trials (Level A Evidence), well-conducted clinical studies (Level B Evidence), or expert opinion (Level C Evidence). 
 
Recommendations
Recommend that speech-language pathologists work collaboratively with health professionals in the management of dysphagia and feeding (Level A Evidence). 
 
  
 
 
 

Evidence-Based Systematic Reviews

Feeding Interventions for Growth and Development in Infants with Cleft Lip, Cleft Palate or Cleft Lip and Palate
Bessell, A., Hooper, L. et al. (2011).
Cochrane Database of Systematic Reviews (2).
 
Description
This is a review of randomized controlled trials investigating the effects of feeding interventions on growth, development and parent satisfaction for infants with cleft lip and palate. 
 
Conclusions
  • Five studies were included which examined various feeding interventions. While there is no evidence to support or refute the type of bottle for best growth outcomes, the authors indicated that squeezable bottles may be easier to use than rigid ones as feeding intervention for infants with cleft lip and/or palate.
  • No evidence was found to support the use of maxillary plates for infants with a unilateral cleft palate.
  • No evidence was found to assess the effects of maternal advice or support.

» See full summary and quality ratings

 
 
 
Benchmarking Clinical Practice Against Best Evidence: An Example from Breastfeeding Infants with Cleft Lip and/or Palate
Mei, C., Morgan, A. T., et al. (2009).
Evidence-Based Communication Assessment and Intervention, 3(1), 48-66. 
 
Description
This is a review of studies investigating the breastfeeding of infants with cleft lip and/or palate. Levels of evidence were assigned as follows: Level 1 (based on a randomized controlled trial [RCT]); Level 2 (based on an RCT with the lower limit of the confidence interval below a meaningful benefit); Level 3 (based on a non-randomized study with a control group); Level 4 (based on a non-randomized study in which outcomes are compared with previous evidence); Level 5 (based on a single-subject design). 
 
Conclusions
  • Support for breastfeeding and occlusion of the cleft to facilitate lip seal was found for infants with cleft lip (Level 4 Evidence).
  • Support for breastfeeding was found for infants with cleft lip and palate (Level 4 Evidence).
  • Support for breastfeeding with infants with cleft palate was weak (Level 4 and 5 Evidence).
  • Based on the limited evidence, future research is warranted.

» See full summary and quality ratings 

 
 

Clinical Expertise/Expert Opinion

 
Consensus Guidelines  
No consensus guidelines were found. 
 
 
 

Client/Patient/Caregiver Perspectives

 
No information was found pertaining to client/patient/caregiver perspectives.
 
 
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