Flexible palatal obturator plate for breastfeeding a baby with cleft lip and palate – case report
Keywords:Cleft palate; Breast Feeding; Craniofacial abnormalities.
Cleft lip and palate are congenital malformations originated from the lack of fusion of the maxillary and midnasal processes. Children with these defects have facial anatomical impairment, which can prevent or hinder the performance of important functions, including breastfeeding. In this context, the multidisciplinary surgical treatment of cleft lip and palate is essential for the health of the child with orofacial anomaly and for a good maternal-infant relationship. In newborns, less invasive treatments can efficiently contribute to the adequate nutrition of the child until the correction surgery is performed, such as acetate plates, which act as a resource to occlude the fissure, facilitating suction, breathing, avoiding episodes of regurgitation and favoring orofacial growth. The objective and case report: the objective of this article is to report the case of a baby with cleft lip and palate, who had difficulties in adequate feeding due to the inefficient adaptation of the oral cavity with the maternal breast. Due to the patient's young age, requiring the wait for the surgical procedure, it was chosen to make a flexible palatal obturator plate in order to occlude the cleft of the palate and allow the correct breastfeeding. This apparatus was made, after previous molding of the patient's oral cavity, in the palate region, with EVA (Ethylene Copolymer/Vinyl Acetate), showing good adaptation and correct performance of the desired functions. Conclusion: the flexible palatal obturator plate is an effective and safe option of therapy for breastfeeding children with cleft lip and palate who are not old enough for surgical correction of the orofacial defect.
Albergaria, M. et al. (2015). Fendas Lábio-Palatinas: Protocolo de Atuação, O Jornal Dentistry, 22, pp. 20-22.
Bhandari, S., Soni, B. W., & Saini, S. S. (2018). From birth till palatoplasty: Prosthetic procedural limitations and safeguarding infants with palatal cleft. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 36(1), 101–105.
Brahm, P. & Valdés, V. (2017). Benefits of Breastfeeding and Risks Associated with Not Breastfeeding, Revista Chilena de Pediatria, 88 (1), pp. 15-21.
Claudia F, Engel S, Lorena B. & Antonieta P. (2013) Orientación inicial, calidad de consejería y forma de alimentación en niños fissurados. Odontoestomatología, Concepción. 15(21): 145-7.
Costa e Silva L, De Amaral B. & Silva J. (2021) Labiopalatin fissure: literary review; Rev Saúde Mult.1; 9(1): 58-70.
Duarte, G. A. et al. (2015). Feeding Methods for Children with Cleft Lip and/or Palate: A Systematic Review, Brazilian Journal of Otorhinolaryngology, 82 (5), pp. 602-609.
Gorlin, R.J.; Cohen, J.M.M. & Hennekam, R.C.M. (2001) Syndromes of the head and neck. New York: Oxford University Press Inc.. 4 ed.
Goyal M, Chopra R, Bansal K. & Marwaha M. (2014) Role of obturators and other feeding interventions in patients with cleft lip and palate: a review. Eur Arch Paediatr Dent; 15:1-9.
Haque, S. & Alam, M. K. (2014). Common Dental Anomalies in Cleft Lip and Palate Patients, The Malaysian Journal of Medical Sciences, 22 (2), pp. 55-60.
Ize-Iyamu, I. N. & Saheeb, B. D. (2011). Feeding Intervention in Cleft Lip and Palate Babies: A Practical Approach to Feeding Efficiency and Weight Gain, International Association of Oral and Maxillofacial Surgeons, 40 (9), pp. 916-919.
Johnson M. M. (2019). Prenatal Imaging for Cleft Lip and Palate. Radiologic technology, 90(6), 581–596.
Neville B, Allen C. & Damm D. (2004) Patologia: Oral & Maxilofacial. Rio de Janeiro. Guanabara Koogan. 2ª ed.
Pathumwiwatana, P. et al (2010). 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, Journal of the Medical Association of Thailand, 93 (4), pp. 71-77.
Reilly S, Reid J, Skeat J, Cahir P, Mei C. & Bunik M; (2013) Academy of Breastfeeding Medicine. ABM clinical protocol #18: guidelines for breastfeeding infants with cleft lip, cleft palate, or cleft lip and palate, revised, Breastfeed Med. 2013; 8(4): 349-53.
Shkoukani, M. A. et al. (2013). Cleft Lip- a Comprehensive Review, Frontiers in Pediatrics- Pediatric Otolaryngology, 1 (53), pp. 1-10.
SilvaL. D., SouzaS. A. de, SilvaC. A. T. de M. e, Amaral T. A. S. do, CostaS. C. da, VilhenaA. T., CarvalhoL. C. de, DiasJ. H. O., & VasconcelosA. S. de. (2019). Vedamento Parcial de Fissura Labiopalatina Utilizando Placa Obturadora em Resina Acrílica: Relato de Caso. Revista Eletrônica Acervo Saúde, (18), e311.
Silveira G, Luiz J, Weise M & Carla. Representações Sociais das Mães de Crianças Portadoras de Fissuras Labiopalatinas sobre Aleitamento. Pesquisa Brasileira em Odontopediatria e Clínica Integrada . 2008; 8(2):215-221.
Tabaquim M, Vilela L & Benati E.(2016) Habilidades cognitivas e competências prévias para aprendizagem de leitura e escrita de pré-escolares com fissura labiopalatina. Revista Psicopedagogia, São Paulo.; 33(100): 28-36.
Tamasia, G. A. & Sanches, P. F. D. (2016). Importância do Aleitamento Materno Exclusivo na Prevenção da Mortalidade Infantil.
Valente A, Espinoza M, Silva A & Luccia G. (2013) Características dos pacientes submetidos a cirurgias corretivas primárias de fissuras labiopalatinas. Rev Hcpa. Cuiabá.; 4(2): 32-39.
Xepapadeas, A. B., Weise, C., Frank, K., Spintzyk, S., Poets, C. F., Wiechers, C., Arand, J., & Koos, B. (2020). Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans - part I: 3D printed and milled palatal stimulation plate for trisomy 21. BMC oral health, 20(1), 20.
Zheng, J., He, H., Kuang, W., & Yuan, W. (2019). Presurgical nasoalveolar molding with 3D printing for a patient with unilateral cleft lip, alveolus, and palate. American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 156(3), 412–419.
How to Cite
Copyright (c) 2021 Isabella Mousinho Marinho dos Santos; Lucia Rosa Reis de Araújo Carvarlho; Manoel Vieira de Melo Neto; Daiana Saraiva Alves
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.