TRAINING FOR THE MOTHERS OF CHILDREN WITH CLEFT USING INSTRUCTIONAL MANUALS

ABSTRACT

Background/Purpose: Infants with cleft lip and/or palate require special care from birth in order to adapt to the cleft and overcome insufficient suction, difficulties in breastfeeding, insufficient food intake, and malnutrition. Early nutritional intervention, as well as nutritional care and guidance, are extremely important for them to achieve their potential in terms of growth, development, and preparation for surgery. Mothers should receive training and have access to appropriate feeding assistance to optimize their children's nutrition, health, and survival rate. The purpose is to provide feeding assistance by training mothers, using the manuals prepared by our specialized multidisciplinary team. Methods/Description Planning, preparation and dissemination of instruction/educational manuals that are accessible and easy to understand, by the team of otolaryngologists, pediatricians, nurses, nutritionists, speech-language therapist, dental professionals, and lactation specialists who prepared straightforward and fun manuals that have been used since May 2021, in treatment centers all over Brazil. Results: Breastfeeding Manual the importance of breast milk;breast physiology, latching;various breastfeeding positions;expressing breast milk manually or using a pump;best nipple for each cleft, breastfeeding position;burping (eructation);types of milk formulas and dilution, hygiene, and preparation techniques. Manual on Introducing Food and Feeding in the Post-Surgical Feeding and Foods introducing additional foods, food quality and quantity;techniques to offer food;child positioning;food consistency;care after lip surgery (cheiloplasty) and after palate surgery (palatoplasty), such as raising the crib;using bracelets to prevent the child from touching his/ her mouth and thus hindering the healing process;when to change the food consistency;weaning from the bottle and pacifier, and the use of glasses and spoons;recipes. Manual Guide to Anthropometric Measurements teaching mothers to check their children's weight, height, head, thoracic, and brachial circumference and to send this information to nutritionists/pediatricians, for monitoring and interventions, as needed. Conclusions: Since the onset of the COVID-19 pandemic, the need to provide training to the parents of patients with cleft has become increasingly evident, so as to provide nutritional care at home needed for the appropriate growth and development of infants, even with less frequent in-person appointments. Considering that cleft babies begin to be submitted to surgical procedures at 3 months old, nutritional care must include growth, development, and preparation for these surgeries. Providing support for the mothers is essential for them to overcome challenges and to adopt best practices in feeding their children. Training them to do that is certainly the best way. This work was supported by Smile Train, Inc.