Feeding Behavioral Assessment in Children with Cleft Lip and/or Palate and Parental Responses to Behavior Problems

Marzieh Hasanpour, Zohreh Ghazavi, Samaneh Keshavarz


Background: Children with cleft lip and/or palate frequently experience feeding difficulties that may place them at risk of malnutrition. Parents’ negative response to these problems is associated with development of problematic behaviors in the child. This study aimed to investigate feeding behavior in children with cleft lip and/or palate and parental responses to these problems.
Materials and Methods: A total of 120 parents of children (aged 6 months to 6 years) with cleft lip and/or palate were recruited from the Cleft Lip and Palate Clinic in Isfahan University of Medical Sciences, Isfahan, Iran, who gave consent and completed a two‑part questionnaire through interviews. Part A of the questionnaire consisted of 25 items that evaluate children’s feeding behavior during mealtimes and part B consists of 18 items that assess parental response (strategies, feelings, and anxiety) to these problems.

Results: Independent t‑test showed a significant difference in the mean score of feeding behavior in mothers (P = 0.020) and parental responses in fathers (P = 0.030). The Pearson correlation coefficient showed an inverse correlation between behavioral feeding score and children’s interval (P = 0.008, r = −0.381) and direct correlation between parental response
and feeding behavioral difficulties (P = 0.003, r = 0.428).

Conclusions: With regards to the results representing appropriate feeding behaviors in children with cleft lip and/or palate, it is suggested that feeding behavioral assessment is an essential nursing and nonmedical intervention for all children.


Cleft lip; Cleft Palate; Feeding Behavior; Iran; Parent

Full Text:



Wilson D, Moatagnino B, Wilson K. Conditions caused by defects in physical development. In: Hockenberry JM, editor. Wongs nursing care of infants and children, 8th ed. Canada: Mosby Elsevier co; 2013. p. 426‑30.

Goodacre T, Swan MC. Cleft lip and palate: current management. Pediatric and child health 2011;22:40.

Mizuno K, Ueda A, Kani K, Kawamura H. Feeding behaviour of infants with cleft lip and palate. Acta Pædiatr 2002;91:1227-32. Stockholm. ISSN 0803-5253.

Kyle T, Carman S. Nursing care of the child with a gastrointestinal disorder. In: Kyle T, editor. Essential of Pediatric Nursing, 2nd ed. China: Lippincott Williams & Wilkins; 2013. p. 707.

Scott RS, Terri K. Nutrition in children. In: Scott RS, Terri K. New York: Lippincott Williams and Wilkins; 2009. p. 807.

Kasten EF, Schmidt SP, Zickler CF, Berner E, Damian LA, Christian GM, et al. Team Care of the Patient with Cleft Lip and Palate. Curr Probl Pediatr Adolesc Health Care 2008;38:138‑58.

Gahagan Sheila. The development of eating behavior: Biology and context. J Dev Behav Pediatr 2012;33:261‑71.

Who’s certified [internet]. Ashby JM: Feeding therapy and techniques for children with cleft lip/palate. C 2011. Available from: http://opensiuc.lib.siu.edu/cgi/viewcontent.

Datta P. Nutrition in children. In: Datta P, editor. Pediatric nursing. 2nd ed. India: JAYPEE; 2009. p. 47.

Skreitule‑Pikes I, Sebre S, Lubenko J. Child behavior and mother‑Child emotional availability in response to parent training program.procedia social and behavioral sciences 2010;5:1418- 28.

Martins Y, Young RL, Robson DC. Feeding and eating behaviors in children with autism and typically developing children. J Autism Dev Disord 2008;38:1878‑87.

Powers SW, Byars KC, Mitchell MJ, Patton SR, Standiford DA, Dolan LM. Parent report of mealtime behavior and parenting stress in young children with type 1 diabetes and in healthy control subjects. Diabetes Care 2002;25:313‑8.

Schreck KA, Williams K, Smith AF. A Comparison of Eating Behaviors between Children with and without Autism. J Autism Dev Disord 2004;34:433‑8.

Drewett RF, Kasese‑Hara M, Wright C. Feeding behavior in children who failed to thrive, Appetite 2002;40:55‑60.

Chan L, Magarey AM, Daniels LA. Maternal Feeding Practices and Feeding Behaviors of Australian Children Aged 12–36 Months. Matern Child Health 2011;15:1363‑71.

Ramsay M, Martel Ch, Porporino M, Zygmuntowicz C. The Montreal Children’s Hospital Feeding Scale: A brief bilingual screening tool for identifying feeding problems. Paediatr Child Health 2011;16:417‑e17.


  • There are currently no refbacks.