Feeding children in the immediate perioperative period after
          palatoplasty: a comparison between techniques using a cup and a spoon

Trettene, Armando dos Santos; Mondini, Cleide Carolina da Silva Demoro; Marques, Ilza Lazarini

doi:10.1590/S0080-623420130000600007

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Original Article • Rev. esc. enferm. USP 47 (06) • 01 Dec 2013 • https://doi.org/10.1590/S0080-623420130000600007 copy

Feeding children in the immediate perioperative period after palatoplasty: a comparison between techniques using a cup and a spoon ^* * Manuscript adapted from the dissertation “Alimentação da criança em pós-operatório imediato de palatoplastia: comparação entre as técnicas utilizando copo e colher”, Graduate Program in Rehabilitation Science at Hospital for the Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo, 2011.

Authorship SCIMAGO INSTITUTIONS RANKINGS

This prospective study conducted at the Hospital for the Rehabilitation of Craniofacial Anomalies aimed to compare the best technique – a cup or a spoon – for feeding children immediately after palatoplasty. We assessed 44 children and their caregivers during feeding every 4 hours; this generated 176 evaluations: 88 using a cup and 88 using a spoon. The Fisher exact test and the Mann-Whitney test were used for statistical analysis, with a significance level of 5% (p<0.05). When the spoon was used, the percentage of patients with food escaping through the labial commissure was lower (17%; p=0.024, the portion administrated was higher (12%; p=0.029), and coughing was less frequent (13%; p=0.026) compared with use of a cup. We conclude that using a spoon to administer food after palatoplasty is better than using a cup.

Cleft palate; Surgery; Feeding methods; Self care


		Yes		No		Total	p
		N	%	n	%
Caregiver’s difficulty positioning child as requested	Cup	28	32	60	68	88	1.000
	Spoon	27	31	61	69	88
	Total	55	31	121	69	176

Difficulty positioning the child using the requested technique	Cup	28	32	60	68	88	1.000
	Spoon	28	32	60	68	88
	Total	56	32	120	68	176

Coughing episodes during food administration	Cup	4	5	84	95	88	0.121
	Spoon	0	-	88	100	88
	Total	4	5	172	95	176

Choking episodes during food administration	Cup	5	6	83	94	88	0.211
	Spoon	1	1	87	99	88
	Total	6	3	170	97	176

Food escaping by the commissure	Cup	67	76	21	24	88	0.024*
	Spoon	52	59	36	41	88
	Total	119	68	57	32	176

Caregiver showed confidence	Cup	62	70	26	30	88	0.867
	Spoon	64	73	24	27	88
	Total	126	72	50	28	176

Caregiver reported confidence	Cup	61	69	27	31	88	1.000
	Spoon	60	68	28	32	88
	Total	121	69	55	31	176

	Mean	SD	∆%	Median	Minimal	Maximum	P
Cup	144,773	60,420	12	140,000	50,000	400,000	0.029*
Spoon	161,705	51,354		150,000	80,000	300,000

Anatomic localization of surgical procedure		Coughing episodes during feeding

		Yes		No		P

		N	%	N	%
Previous palatoplasty	Cup	–	–	12	7	1.000
	Spoon	–	–	12	7
	Total	–	–	24	14

Posterior palatoplasty	Cup	1	1	29	16	1.000
	Spoon	–	–	30	17
	Total	1	1	59	33

Total palatoplasty	Cup	6	3	40	23	0.026 *
	Spoon	–	–	46	26
	Total	6	3	86	49

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Correspondence addressed to
: Armando dos Santos Trettene. Rua Silvio Marchione 3-20 – Vila Universitária, CEP 17012-900 – Bauru, SP, Brazil