Early repair and breast-feeding for infants with cleft lip.

This study attempts to define the effect of early repair and breast-feeding on the outcome of cleft lip surgery. The first part deals with 100 consecutive cleft lip repairs categorized retrospectively by age at operation. Forty-nine patients were operated on during the first 3 weeks of life; 51 at an older age. There were no statistically significant differences in complication rate between the groups (14 and 18 percent, respectively). A subgroup of 26 infants was operated on at a week or less of age; these sustained significantly fewer complications (8 percent). There was no apparent difference in the operative results as defined by whether or not the child needed a subsequent revision. A second group of 60 mothers was offered the choice of breast-feeding their babies immediately following operation. Sixteen breast-fed for a minimum of 6 weeks, 22 were fed by means of a cup or syringe, and 22 started breast-feeding but converted to a bottle within 6 weeks. No complications attributable to breastfeeding were observed, and the rate of weight gain was definitely enhanced in the breast-feeding group. Hospital stay was shortened by an average of over a day (33 percent) as compared with those fed by cup. This effect was related to the easier transition from IV administration to oral intake when breast-fed. We are currently encouraging early repair and breast-feeding in the full-term baby as the optimum method of management of newborns with cleft lip.