The Impact of Human Milk on Tympanostomy Tube,Hearing,and Speech Sequelae in Children With Cleft Palate

Abstract

Objective

To determine whether human milk feeding in children with cleft palate (CP ± L) reduces tympanostomy tubes and improves hearing, speech, and language outcomes.

Design

Retrospective cohort study.

Setting

Tertiary children's hospital at a Cleft Craniofacial Specialty Clinic.

Patients, Participants

319 children with CP ± L who were born between April 2005 and April 2015 were included.

Interventions

Impacts on otological, hearing, and speech/language outcomes were analyzed in children fed human milk for any duration, ≥3 months, and ≥6 months.

Main Outcome Measure(s)

Tympanostomy tube placement history, hearing status before and after tube placement, and speech/language development at 2 and 5 years of age.

Results

Children with CP ± L fed human milk for ≥3 months (143/319, 44.8%) had decreased odds of abnormal hearing tests (odds ratio [OR]: 0.174, 95% confidence interval [CI]: 0.0266-0.845) or tympanograms (OR: 0.059, 95% CI: 0.008-0.936) before tube placement and decreased odds of bilateral effusion at tube placement (OR: 0.236, 95% CI: 0.089-0.628), even when accounting for Robin sequence and insurance type. There was no significant association between human milk feeding and hearing after tube placement. However, language delays (OR: 0.279, 95% CI: 0.084-0.930) and speech sound production disorder (OR: 0.488, 95% CI: 0.246-0.967) at 5 years of age were less common in those who received human milk of any duration.

Conclusions

Feeding human milk to children with CP ± L was associated with improved otological, hearing, speech, and language outcomes. Despite the known challenges of feeding infants with CP ± L, this study demonstrates the added benefits of human milk in this population.