The Case Report: Unusually Complicated Dysphagia Management in Three Cleft Palate Newborns

Management of Cleft Palate Newborns

Abstract

Fundamental concern in treatment of newborns with cleft palate is safe and adequate oral feeding. In term of feeding  use and obturator to cover the cleft promotes feeding,  reduces choking and feeding time is a generally suggested.  However, in more complicated condition such as dysphagia  appropriate management should be considered. This report reviewed the management of three cleft palate newborns  with unusual complicated dysphagia. The population was  cleft palate newborns of Phranangklao Hospital in 2017-18. Treatments were feeding facilitating technique, trigeminal nerve and sucking swallowing neuromuscular coordination stimulation, feeding positioning and slow rhythmic feeding. Two infants were not found aspiration. Another infant with  congenital laryngomalacia, cerebral palsy found Gerd  bronchitis and pneumonia. For one year to one year nine  month follow up, first case gained body weight less than  normal criteria, second case gained quite low and third case gained normal weight. They got an appointment for  palatoplasty. Only one underwent surgery, two of them lost  contact. Finding the causes of dysphagia by  multidisciplinary team lead to appropriated management  that avoid prolong use of orogastric tube or percutaneous  endoscopic gastrostomy and gain adequate body weight  for palatoplasty