EATING AND SWALLOWING DISORDERS IN CHILDREN WITH CLEFT LIP AND/OR PALATE
Keywords:
cleft lip, cleft palate, eating disorder, dysphagia
Abstract
Cleft lip and palate are complex congenital anomalies of the orofacial system of children. Feeding and swallowing problems occur with varying degrees in children with cleft lip and/or palate. The extent of the cleft is related to the severity of eating and swallowing disorders, so the most common problems are: decreased oral sensitivity, cough, choking, nasal regurgitation, difficulty in sucking, laryngotracheal aspiration, due to inadequate airway protection during swallowing, which may result in pneumonia and lung damage. Feeding and swallowing difficulty is also a source of stress for parents. Therefore, it is of great importance to identify the problems of feeding and swallowing in a timely manner, along with modifications of the feeding method.
The aim of this paper is to review the literature and available evidence regarding the types of eating and swallowing disorders that can be identified in children with cleft lip and/or palate, as well as a description and types of compensatory strategies and interventions to alleviate difficulties.
References
1. Watkins SE, Meyer RE, Strauss RP, Aylsworth, AS. Classification, Epidemiology, and Genetics of Orofacial Clefts. Clinics in Plastic Surgery. 2014; 41(2):149–63.
2. Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet. 2011; 12(3):167-78.
3. Mitić V, Jonović M, Mitić N, Mitić A, Mitić D, Stojanović M, et.al. Incidence of Lip and Palate Clefts in Children in Niš from 1990 to 2007. Srp Arh Celok Lek. 2011;139(5-6):298-303.
4. Santos EC, Leite SGS, Santos SMP, Neves ZF, Passos XS, Silveira FFCF. Análise qualitativa do padrão alimentar de crianças portadoras de fissura de lábio e/ou palato atendidas em um hospital de Goiânia-Go. J Health Sci Inst.2011;29(3):183-5.
5. Rahimov F, Jugessur A, Murray JC. Genetics of nonsyndromic orofacial clefts. Cleft Palate Craniofac J. 2012;49(1):73-91.
6. Gatti, G, Freda N, Giacomina A, Montemagni M & Sisti A. Cleft Lip and Palate Repair. J of Craniofacial Surgery. 2017;28(8):1918-24.
7. Fisher DM, Sommerlad BC. Cleft lip, cleft palate, and velopharyngeal insufficiency. Plast Reconstr Surg. 2011;128(4):342-60.
8. Sommerlad BC. Cleft palate repair. In: Losee JE, Kirschner R, eds. Comprehensive Cleft Care. New York: McGraw-Hill; 2009:399–412.
9. Falzone SJ, Trost-Cardamone, MP Karnell, M Hardin-Jones The Clinician’s Guide to Treating Cleft Palate Speech. Mosby Elsevier: Philadelphia; 2006.
10. Shkoukani MA, Lawrence LA, Liebertz DJ, Svider PF. Cleft palate: a clinical review. Birth Defects Res C Embryo Today. 2014;102(4):333-42.
11. McMurray J, Hoffman M, Braden M. Multidisciplinary management of pediatric voice and swallowing disorders. Springer; 2019.
12. Murry T, Carrau R, Murry T. Clinical manual of swallowing disorders. San Diego: Plural Pub.; 2006.
13. Shaw SM, Martino R. The normal swallow: muscular and neurophysiological control. Otolaryngol Clin N Am. 2013;46:937–56.
14. Logemann J. Evaluation and treatment of swallowing disorders. Austin, Tex: Pro-Ed; 2000.
15. Moon HI, Yoon SY, Yi TI, Jeong YJ, Cho TH. Lesions Responsible for Delayed Oral Transit Time in Post-stroke Dysphagia. Dysphagia 2018;33(3):321-8.
16. Groher M, Crary M. Dysphagia. 2nd ed. Elsevier, Mosby; 2015.
17. Hennessy M, Goldenberg D. Surgical anatomy and physiology of swallowing. Oper Tech Otolaryngol. 2016;27:60–6.
18. Shah S, Garriano F. Pediatric oral anatomy. Oper Tech Otolaryngol Head Neck Surg. 2015;26:2–7.
19. Shaw SM, Martino R. The normal swallow:muscular and neurophysiological control. Otolaryngol Clin N Am. 2013;46:937–56.
20. Chavan K. Anatomy of swallowing. In: Mankekar G, editor. Swallowing-physiology, disorders, diagnosis, and therapy. New Delhi: Springer; 2015. p. 1–20.
21. Morris S, Klein M. Pre-feeding skills. TSB/Harcourt; 2000.
22. Stiles J, Jernigan T: The basics of brain development. Neuropsychol Rev. 2010;20(4):327.
23. Durvasula, VSPB, O’Neill AC, Richter GT. Oropharyngeal Dysphagia in Children. Otolaryngologic Clinics of North America.2014;47(5):691–720.
24. Derkay CS, Schechter GL. Anatomy and physiology of pediatric swallowing disorders. Otolaryngol Clin N Am. 1998;31:397–404.
25. Dodrill P. Feeding problems and oropharyngeal dysphagia in children. J Gastroenterol Hepatol Res 2014; 3:1055–60.
26. Leopold N, Kagel M. Pharingo-Esofageal dysphagia in Parkinsons disease. Dysphagia. 1997;7(1):11-18.
27. Jelenc N, Eberlinc A, Hočevar Boltežar I. Feeding and swallowing disorders in children with clefts in the orofacial region. ZdravVestn. 2019;88(9-10):405-4.
28. Freitas, J. da S., & Cardoso, M. C. de A. F. Sintomas de disfagia em crianças com fissura labial e/ou palatina pré e pós-correção cirúrgica. CoDAS. 2018;30(1).
29. Branco LL, Cardoso MCAF. Alimentação no recém-nascido com fissuras labiopalatinas. Universitas. Ciênc Saúde. 2013;11(1):57-70.
30. Campillay PL, Delgado SE, Brescovici SM. Avaliação da alimentação em crianças com fissura de lábio e/ou palato atendidas em um hospital de Porto Alegre. Rev CEFAC. 2010;12(2):257-66.
31. De Vries IA, Breugem CC, van der Heul AM, Eijkemans MJ, Kon M, Mink van der Molen AB. Prevalence of feeding disorders in children with cleft palate only: a retrospective study. Clin Oral Investig. 2014;18(5):1507-15.
32. Trenouth MJ, Campbell AN. Questionnaire evaluation of feeding methods for cleft lip and palate neonates. Int J Paediatr Dent. 1996;6(4):241-4.
33. Britton K, McDonald S, Welbury R. An investigation into infant feeding in children born with a cleft lip and/or palate in the West of Scotland. European Archives of Pediatric Dentistry. 2011;12(5):250-55.
34. Freitas Jordana da Silva, Cardoso Maria Cristina de Almeida Freitas. Sintomas de disfagia em crianças com fissura labial e/ou palatina pré e pós-correção cirúrgica. 2018;30(1).
35. Reid J, Kilpatrick N, Reilly S. A prospective, longitudinal study of feeding skills in a cohort of babies with cleft conditions. Cleft Palate Craniofac J. 2006;43(6):702-9.
36. Ongkasuwan J, Chiou E. Pediatric Dysphagia. Cham: Springer; 2018.
37. Reid J, Reilly S, Kilpatrick N. Sucking performance of babies with cleft conditions. Cleft Palate Craniofac J. 2007;44(3):312-20.
38. Arvedson JC, Brodsky L, Arvedson JC, Brodsky LB. Feeding with craniofacial anomalies. In:Arvedson JC, Brodsky LB, editors. Pediatric swallowing and feeding: assessment and management. 2002;527–61.
39. Nagaoka K, Tanne K. Activities of the Muscles Involved in Swallowing in Patients with Cleft Lip and Palate. Dysphagia. 2007;22(2), 140–4.
40. Jarc A, Hočevar Boltežar I. Skrb za osebe z razcepom ustnic, čeljusti in neba v Sloveniji = Care for subjects with orofacial clefts in Slovenia. In: Destovnik K, Ulaga J, eds. Družbena skrb za vzgojo, izobraževanje in socialno varstvo oseb s posebnimi potrebami - deset let kasneje: zbornik referatov. … [2nd International Alps-Adria Countries Congress], Portorož, 18.-20. oktober 2000. Ljubljana: Društvo defektologov Slovenije, 2000: 631-6.
41. Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet. 2009 Nov 21;374(9703):1773-85.
42. Šašić M. Učestalost kombinovanih rascepa primarnog i sekundarnog palatuma u odnosu na pol, lokalizaciju. stepen izraženosti i morfologiju. Stomatološki glasnik Srbije.1996;43:85-90.
43. Duffy KL. Dysphagia in Children. Current Problems in Pediatric and Adolescent Health Care. 2018;48(3),71–73.
44. Miller CK. Feeding issues and interventions in infants and children with clefts and craniofacial syndromes. Seminars in Speech and Language. 2011;32(2):115-26.
45. Wolf L, Class R. Feeding and Swallowing Disorders in Infancy. Pediatric Physical Therapy. 1993;5(4).
46. Reid J. A Review of Feeding Interventions for Infants With Cleft Palate. The Cleft Palate-Craniofacial Journal. 2004;41(3),268–278.
2. Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet. 2011; 12(3):167-78.
3. Mitić V, Jonović M, Mitić N, Mitić A, Mitić D, Stojanović M, et.al. Incidence of Lip and Palate Clefts in Children in Niš from 1990 to 2007. Srp Arh Celok Lek. 2011;139(5-6):298-303.
4. Santos EC, Leite SGS, Santos SMP, Neves ZF, Passos XS, Silveira FFCF. Análise qualitativa do padrão alimentar de crianças portadoras de fissura de lábio e/ou palato atendidas em um hospital de Goiânia-Go. J Health Sci Inst.2011;29(3):183-5.
5. Rahimov F, Jugessur A, Murray JC. Genetics of nonsyndromic orofacial clefts. Cleft Palate Craniofac J. 2012;49(1):73-91.
6. Gatti, G, Freda N, Giacomina A, Montemagni M & Sisti A. Cleft Lip and Palate Repair. J of Craniofacial Surgery. 2017;28(8):1918-24.
7. Fisher DM, Sommerlad BC. Cleft lip, cleft palate, and velopharyngeal insufficiency. Plast Reconstr Surg. 2011;128(4):342-60.
8. Sommerlad BC. Cleft palate repair. In: Losee JE, Kirschner R, eds. Comprehensive Cleft Care. New York: McGraw-Hill; 2009:399–412.
9. Falzone SJ, Trost-Cardamone, MP Karnell, M Hardin-Jones The Clinician’s Guide to Treating Cleft Palate Speech. Mosby Elsevier: Philadelphia; 2006.
10. Shkoukani MA, Lawrence LA, Liebertz DJ, Svider PF. Cleft palate: a clinical review. Birth Defects Res C Embryo Today. 2014;102(4):333-42.
11. McMurray J, Hoffman M, Braden M. Multidisciplinary management of pediatric voice and swallowing disorders. Springer; 2019.
12. Murry T, Carrau R, Murry T. Clinical manual of swallowing disorders. San Diego: Plural Pub.; 2006.
13. Shaw SM, Martino R. The normal swallow: muscular and neurophysiological control. Otolaryngol Clin N Am. 2013;46:937–56.
14. Logemann J. Evaluation and treatment of swallowing disorders. Austin, Tex: Pro-Ed; 2000.
15. Moon HI, Yoon SY, Yi TI, Jeong YJ, Cho TH. Lesions Responsible for Delayed Oral Transit Time in Post-stroke Dysphagia. Dysphagia 2018;33(3):321-8.
16. Groher M, Crary M. Dysphagia. 2nd ed. Elsevier, Mosby; 2015.
17. Hennessy M, Goldenberg D. Surgical anatomy and physiology of swallowing. Oper Tech Otolaryngol. 2016;27:60–6.
18. Shah S, Garriano F. Pediatric oral anatomy. Oper Tech Otolaryngol Head Neck Surg. 2015;26:2–7.
19. Shaw SM, Martino R. The normal swallow:muscular and neurophysiological control. Otolaryngol Clin N Am. 2013;46:937–56.
20. Chavan K. Anatomy of swallowing. In: Mankekar G, editor. Swallowing-physiology, disorders, diagnosis, and therapy. New Delhi: Springer; 2015. p. 1–20.
21. Morris S, Klein M. Pre-feeding skills. TSB/Harcourt; 2000.
22. Stiles J, Jernigan T: The basics of brain development. Neuropsychol Rev. 2010;20(4):327.
23. Durvasula, VSPB, O’Neill AC, Richter GT. Oropharyngeal Dysphagia in Children. Otolaryngologic Clinics of North America.2014;47(5):691–720.
24. Derkay CS, Schechter GL. Anatomy and physiology of pediatric swallowing disorders. Otolaryngol Clin N Am. 1998;31:397–404.
25. Dodrill P. Feeding problems and oropharyngeal dysphagia in children. J Gastroenterol Hepatol Res 2014; 3:1055–60.
26. Leopold N, Kagel M. Pharingo-Esofageal dysphagia in Parkinsons disease. Dysphagia. 1997;7(1):11-18.
27. Jelenc N, Eberlinc A, Hočevar Boltežar I. Feeding and swallowing disorders in children with clefts in the orofacial region. ZdravVestn. 2019;88(9-10):405-4.
28. Freitas, J. da S., & Cardoso, M. C. de A. F. Sintomas de disfagia em crianças com fissura labial e/ou palatina pré e pós-correção cirúrgica. CoDAS. 2018;30(1).
29. Branco LL, Cardoso MCAF. Alimentação no recém-nascido com fissuras labiopalatinas. Universitas. Ciênc Saúde. 2013;11(1):57-70.
30. Campillay PL, Delgado SE, Brescovici SM. Avaliação da alimentação em crianças com fissura de lábio e/ou palato atendidas em um hospital de Porto Alegre. Rev CEFAC. 2010;12(2):257-66.
31. De Vries IA, Breugem CC, van der Heul AM, Eijkemans MJ, Kon M, Mink van der Molen AB. Prevalence of feeding disorders in children with cleft palate only: a retrospective study. Clin Oral Investig. 2014;18(5):1507-15.
32. Trenouth MJ, Campbell AN. Questionnaire evaluation of feeding methods for cleft lip and palate neonates. Int J Paediatr Dent. 1996;6(4):241-4.
33. Britton K, McDonald S, Welbury R. An investigation into infant feeding in children born with a cleft lip and/or palate in the West of Scotland. European Archives of Pediatric Dentistry. 2011;12(5):250-55.
34. Freitas Jordana da Silva, Cardoso Maria Cristina de Almeida Freitas. Sintomas de disfagia em crianças com fissura labial e/ou palatina pré e pós-correção cirúrgica. 2018;30(1).
35. Reid J, Kilpatrick N, Reilly S. A prospective, longitudinal study of feeding skills in a cohort of babies with cleft conditions. Cleft Palate Craniofac J. 2006;43(6):702-9.
36. Ongkasuwan J, Chiou E. Pediatric Dysphagia. Cham: Springer; 2018.
37. Reid J, Reilly S, Kilpatrick N. Sucking performance of babies with cleft conditions. Cleft Palate Craniofac J. 2007;44(3):312-20.
38. Arvedson JC, Brodsky L, Arvedson JC, Brodsky LB. Feeding with craniofacial anomalies. In:Arvedson JC, Brodsky LB, editors. Pediatric swallowing and feeding: assessment and management. 2002;527–61.
39. Nagaoka K, Tanne K. Activities of the Muscles Involved in Swallowing in Patients with Cleft Lip and Palate. Dysphagia. 2007;22(2), 140–4.
40. Jarc A, Hočevar Boltežar I. Skrb za osebe z razcepom ustnic, čeljusti in neba v Sloveniji = Care for subjects with orofacial clefts in Slovenia. In: Destovnik K, Ulaga J, eds. Družbena skrb za vzgojo, izobraževanje in socialno varstvo oseb s posebnimi potrebami - deset let kasneje: zbornik referatov. … [2nd International Alps-Adria Countries Congress], Portorož, 18.-20. oktober 2000. Ljubljana: Društvo defektologov Slovenije, 2000: 631-6.
41. Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet. 2009 Nov 21;374(9703):1773-85.
42. Šašić M. Učestalost kombinovanih rascepa primarnog i sekundarnog palatuma u odnosu na pol, lokalizaciju. stepen izraženosti i morfologiju. Stomatološki glasnik Srbije.1996;43:85-90.
43. Duffy KL. Dysphagia in Children. Current Problems in Pediatric and Adolescent Health Care. 2018;48(3),71–73.
44. Miller CK. Feeding issues and interventions in infants and children with clefts and craniofacial syndromes. Seminars in Speech and Language. 2011;32(2):115-26.
45. Wolf L, Class R. Feeding and Swallowing Disorders in Infancy. Pediatric Physical Therapy. 1993;5(4).
46. Reid J. A Review of Feeding Interventions for Infants With Cleft Palate. The Cleft Palate-Craniofacial Journal. 2004;41(3),268–278.
Published
2025/12/19
Section
Pregledni rad / Review article