Práticas alimentares de crianças com fissuras orais: da amamentação à introdução alimentar

Abstract

Oral clefts are congenital malformations in the orofacial region that affect approximately 348,000 babies per year worldwide. They can be classified as cleft lip, palate or lip and palate, and can be caused by genetic, environmental and other factors. In children, this malformation causes damage to the sucking and swallowing mechanisms, in addition to excessive air intake, longer feeding time, nasal regurgitation, and eructation. Thus, it is extremely important to provide specialized health care to babies born with oral cleft, since there may be damage to their growth and development caused by inadequate nutrition. Considering the scarcity of studies on the introduction of food in children with cleft lip and/or palate, the aim of this study was to describe how this process occurs in this population, as well as the methods and strategies adopted by those responsible for it. An observational, cross-sectional, descriptive study was developed with parents and/or guardians of children with oral clefts who attend rehabilitation centers in Rio Grande do Norte and who are going through or have gone through the phase of food introduction. A semi-structured questionnaire was applied to 16 parents and/or guardians. The most frequent clefts were cleft palate (43.8%) and cleft lip (43.8%), followed by cleft lip (6.3%). Most children (62.5%) had already had surgery for cleft correction, in an age range of 4 months to 1 year and 6 months. Most children (93.8%) did not receive exclusive breastfeeding during the first 6 months of life, and 6.3% were not breastfed at any stage of life. Regarding food introduction, it was observed that the food groups most consumed daily were dairy products (81.3%), processed cereal-based foods (75.0%) and vegetables (62.5%). As for the degree of difficulty in some aspects related to feeding and its association with the type of oral cleft, the majority of children with cleft lip presented no or low difficulty in swallowing liquid, pasty and solid foods; nasal regurgitation, difficulty in sucking, chewing and swallowing; choking, vomiting, tiredness, escape of food through the nose and/or the mouth, excessive ingestion of air and constant eructation during feeding. Those with cleft palate or cleft lip and palate showed a higher degree of difficulty (medium/high/extreme), but without statistical significance. We concluded that there is a low frequency of exclusive breastfeeding in these cases, in which 93.8% of the children did not receive breastfeeding as recommended by the World Health Organization (WHO). Furthermore, it could be observed that there is a great variability of factors that interfere in food intake and in the presence or absence of difficulties, especially in cases of children with cleft lip and palate.