***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Using a disposable syringe to feed 1 - 14-week-old babies with cleft lip and palate ( CLP ) was studied . 57 CLP babies were r and omly divided into : syringe-fed ( intervention ) and cup- and -spoon-fed groups and compared with 55 normal breast- or bottle-fed babies . Differences in weight gained from birth to 6 , 10 and 14 weeks were compared . Syringe-fed CLP babies fed breast milk had a significant difference in weight gain ( 0.7 and 0.8 kg ) compared with cup- and -spoon-fed babies ( 0.4 kg ) , at 10 and 14 weeks , respectively . Normal breast-fed babies gained 0.6 and 0.7 kg . Cup- and -spoon-fed CLP babies fed artificial and breast milk gained 0.5 and 0.6 kg ; syringe-fed CLP babies gained 0.6 and 1.2 kg . Normal babies gained 1.0 and 1.7 kg for the same age and food . Average feeding times were 10 ml/1.25 min for syringe-fed and 10 ml/2.08 min for cup- and -spoon-fed CLP babies at 6 weeks . 19 ( 100 % ) cup- and -spoon-fed babies exhibited spill and regurgitation at 6 weeks compared with 30 ( 79 % ) CLP syringe-fed babies ( P<0.05 ) . In both groups spill and regurgitation decreased with age . CLP babies fed with the modified method had a faster feeding time , less spill and regurgitation and gained the same weight as normal babies at 10 and 14 weeks It has been a tradition for plastic surgeons to withhold breast feeding from babies after cleft lip repair to prevent wound disruption . A prospect i ve , r and omised trial of 40 infants showed that early postoperative breast feeding after cleft lip repair is safe , results in more weight gain at 6 weeks after surgery ( P < 0.01 ) and is more economical than spoon feeding OBJECTIVE To compare two feeding methods advocated for infants with cleft palate : ( a ) a squeezable plastic container with a narrow , long crosscut nipple ( squeezable cleft palate nurser ) ; and ( b ) a st and ard nipple with a crosscut ( crosscut nipple ) . The effectiveness of a nutrition intervention protocol for these infants was also documented . DESIGN Thirty-one infants ( median age = 15 days ) were r and omized to one of two feeding methods ( 18 infants , squeezable cleft lip/palate nurser ; 13 infants , crosscut nipple ) within sex ( 21 boys , 10 girls ) and palatal defect ( 22 cleft lip and palate , 9 isolated cleft palate ) categories . The intervention included feeding technique instructions , nutrition counseling at each clinic visit , use of the same 20 kcal/oz st and ard formula for 12 months , and introduction of infant and soft table foods at 6 months . Four-day food records and growth data were obtained . MAIN OUTCOME MEASURES Mean energy and protein intakes at 3 and 6 months of age and growth measurements during the first 18 months of life were obtained . STATISTICAL ANALYSES A repeated measures analysis of variance for intakes was performed with time as the repeated measure and feeding method as the covariable . Similar analyses were completed for growth measures with sex and feeding method as covariates . RESULTS Mean energy intake at 3 and 6 months of age ( P = .24 ) and growth measurements during the first 18 months of life ( P values : weight gain [ grams per day ] , .73 ; weight , .21 ; length , .07 ; head circumference , .18 ; triceps and subscapular skinfolds and mid-arm circumference , .47 , .48 , and .69 , respectively ) were not significantly different . Both feeding methods were effective in supporting normal growth . APPLICATIONS With adequate instruction related to the use of either feeding technique and close nutrition follow-up early in infancy , a dietitian or other health care practitioner may advise the use of either feeding method . These data support the need for feeding and nutrition education and early nutrition intervention This prospect i ve study conducted at the Hospital for the Rehabilitation of Craniofacial Anomalies aim ed 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 OBJECTIVE To compare the effectiveness of squeezable and rigid feeding bottles for infants with clefts . DESIGN Patients were r and omly assigned at birth to feeding with a squeezable bottle ( assisted feeding ) or to feeding with a rigid bottle and were followed for 1 year . The data were analyzed on the basis of intention to treat . SETTING The trial was conducted within the existing arrangements for hospital and home care for children with clefts within the National Health Service in the north of Engl and . PATIENTS The patients were 101 consecutively born children with cleft lip and /or palate who were otherwise healthy . All patients completed the trial . Two were excluded from the analysis when unrelated developmental problems became apparent . MAIN OUTCOME MEASURES Anthropometric measures -nude weight , crown-heel length ( CHL ) , and occipito-frontal circumference (OFC)-were recorded . RESULTS There were statistically significant differences between the two groups in weight at 12 months ( p = .038 , with an adjusted mean difference of 0.43 kg ) and in head circumference ( p = .004 with an adjusted mean difference of 0.77 cm ) , indicating increased growth in the squeezable bottle group . The difference in CHL was not significant at conventional levels ( p = .082 ) . Whereas 25 of 52 ( 48 % ) rigid bottles required modification by the health visitor , this was needed for only 4 of 49 ( 8 % ) squeezable bottles . There was a highly significant difference when numbers of modifications for each method were compared ( p < .0001 ) . Despite modifications , six infants feeding with a rigid bottle ( 11 % ) were transferred to a squeezable bottle due to problems with feeding , but none were transferred from squeezable to rigid bottles . Thus , the squeezable bottle generally appeared to be a more satisfactory method , requiring less support or intervention after initial instruction . CONCLUSIONS Both feeding methods achieved similar anthropometric outcomes , with a beneficial effect on head circumference and weight in the assisted feeding group . We recommend that this last observation be treated with caution . The squeezable bottles were easier to use , and we recommend that they be routinely prescribed Objective To evaluate the nutritional status and behavior of the surgical wound following cheiloplasty .  Setting Hospital for Rehabilitation of Craniofacial Anomalies , University of São Paulo ( HRAC/USP ) , Bauru , São Paulo , Brazil . Participants Forty-five nursing children aged 3 to 13 months old , either bottle-fed or spoon-fed , su bmi tted to cheiloplasty during the study period . Results The results did not demonstrate significant differences between the study groups regarding gender , age , nutritional status , and condition of the surgical wound . Upon completion of the study , the infants of both groups were eutrophic , presenting increase in growth and development , with no hematoma , significant edema , sutural dehiscence , bleeding , or infection at the operated area . Conclusions Both kinds of nursing , spoon- and bottle-feeding , had the same influence on nutritional status and wound condition in both study groups . We suggest that bottle-feeding should be tried in patients in the postoperative period of cheiloplasty , because this method was used after surgery without causing any damage to the lip surgical wound Although bottle-feeding after cheiloplasty is widely accepted , postoperative feeding regimen after palatoplasty is still controversial . The aim of this prospect i ve r and omized study was to evaluate the effect of bottle-feeding on early postoperative course after palatoplasty in a relatively homogeneous group of patients . Eighty-two consecutive patients with nonsyndromic cleft palate undergoing 2-flap palatoplasty by a single surgeon were r and omized to feeding from a bottle with the usual nipple ( G1 , N = 42 ) or to feeding with a spoon , cup , or syringe ( G2 , N = 40 ) . Complication rates , postoperative sedative use , oral intake for the first 6 days , and relative weight gain at 1 and 2 months were compared . There were no significant complications such as bleeding or respiratory problem . The overall complication rate including wound dehiscence and oronasal fistula was similar in G1 and G2 ( 11.9 % versus 12.5 % , P = 1.000 ) as was postoperative sedative use and mean daily oral intake for the first 5 days . Mean intake on the sixth day was significantly higher in G1 . There were no significant between-group differences in relative weight gain after 1 and 2 months . In conclusion , bottle-feeding had no adverse effect on the early postoperative course after palatoplasty including complication rate , oral intake , and weight gain . These findings suggest that an unrestricted feeding regimen is appropriate immediately after palatoplasty Objective To compare the efficacy of the three feeding techniques commonly used in authors ’ setup in improving the weight gain pattern of children with orofacial cleft . Methods A cohort prospect i ve study was employed . A total sample of 150 infants at the age of 2 mo with cleft of both lip and palate were recruited and followed bimonthly until their first birthday to assess the pattern of weight gain . The subjects were categorized into three groups based on their habitual feeding techniques such as Group I : Paladai fed ; Group II : Bottle fed and Group III : Spoon fed with 50 subjects in each group . The three groups were counseled on nutritional aspects , correct infant positioning and hygienic practice s. Results The mean weight of the Group I subjects was observed to be higher than the other two groups at every visit and was also found to be statistically significant at p < 0.001 . Over all comparison proved that the weight gain of 1.364 ± 0.191 , 1.348 ± 0.284 and 1.450 ± 0.205 and the velocity of weight gain , kg per week of 0.17 ± 0.023 , 0.168 ± 0.035 and 0.181 ± 0.025 of Group I at 4 , 6 and 8th mo respectively were significantly higher than the other two groups ( p < 0.001 ) . Conclusions Of the three feeding techniques adopted by the mothers of infants with orofacial cleft , it was noted that paladai feeding was better than the bottle or spoon-feeding AIMS To determine the effect of nasogastric ( NG ) feeding compared with oral feeding on morphine requirements after primary cleft palate repair , and secondarily on enteral intake . METHODS This was a pilot study involving 50 infants , aged five to ten months , who were r and omised to receive NG or oral feeding after palate repair . All infants received the same anaesthetic and analgesic management . Post-operatively , paracetamol and ibuprofen were administered regularly and intravenous ( IV ) morphine was given on dem and using a nurse-controlled analgesia device . The primary outcome measure was the total morphine consumption in the first 24 hours . Secondary outcome measures included the numbers of painful episodes and the volumes of IV fluid and enteral feed administered . RESULTS Of the 50 infants enrolled , 18 and 23 received either NG or oral feeding , respectively , and completed the study . Numbers of painful episodes and morphine consumption in the first 24 hours were similar in each group . Volumes of feed administered in the first 24 hours were significantly different : the NG group received approximately three times more than the oral group . Nine of the oral group required IV fluids in the 24 hours compared with none in the NG group . CONCLUSION NG feeding was more effective than oral feeding in the first 24 hours after surgery , but numbers of painful episodes recorded were similar . Further research is required 
    Output:
    
Likewise , the post-lip repair studies showed better results with  suction methods .
CONCLUSION The studies show that prior to surgical repair , the use of alternative methods can be beneficial .
In the postoperative period following lip repair , methods with suction are more beneficial .
However , in the postoperative period of palatoplasty , there are divergences of opinion regarding the most appropriate feeding methods