***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: Objective : Feeding difficulties are reported widely in infants with cleft lip and / or palate . There is , however , a paucity of objective information about the feeding patterns of these infants . This study compared patterns of feeding in infants with unrepaired cleft lip and palate with healthy noncleft infants of a similar age . Setting : North Thames Regional Cleft Centre . The noncleft cohort was recruited from West Middlesex University Hospital , a general hospital with similar demographics . Participants : Fifty newborn infants with nonsyndromic complete unilateral cleft lip and palate or a cleft of the soft and at least two thirds of the hard palate who were referred to the North Thames Regional Cleft Centre participated . Parents of 20 r and omly selected , noncleft infants agreed to participate . Main Outcome Measures : Feeding patterns were rated using the Neonatal Oral Motor Assessment Scale . Additional objective information was collected using the Great Ormond Street Measurement of Infant Feeding ( Masarei et al. , 2001 ; Masarei , 2003 ) . Results : Infants with nonsyndromic complete unilateral cleft lip and palate or a cleft of the soft and at least two thirds of the hard palate had less efficient sucking patterns than their noncleft peers had . They used shorter sucks ( mean difference , 0.30 second ; p < .0005 ) , a faster rate of sucking ( mean difference , 34.20 sucks/second ; p < .0005 ) , higher suck-swallow ratios ( mean difference , 1.87 sucks/swallow ; p < .0005 ) , and a greater proportion of intraoral positive pressure generation ( mean difference , 45.97 % positive pressure ; p < .0005 ) . Conclusions : This study demonstrated that the sucking patterns of infants with nonsyndromic complete unilateral cleft lip and palate or a cleft of the soft and at least two thirds of the hard palate differ from those of their noncleft peers 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 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 
    Output:
    
A cleft lip and /or a cleft palate can occur separately , although they are more likely to occur together early in pregnancy .
These anomalies can be surgically repaired .
Without proper treatment , patients have aesthetic and functional problems , such as feeding disorders , otitis media and speech difficulties .
Although such infants suckle with weakened pressure , these nipples enable them to drink milk by lightly pushing them through their lip .
Changes in feeding methods seem to stress the infants and cause them to cry , which places tension on the wound .
These alternative feeding methods may also have other impacts on surgical wound healing .
A systematic review suggested that alternative feeding methods were associated with less postoperative weight gain in patients than traditional feeding methods .
Postoperative nutritional intake also influences wound healing .
However , no strong evidence has been presented to show that breastfeeding or bottle-feeding after cleft lip repair may cause surgical wound dehiscence among infants with cleft lip .
If breastfeeding or bottle-feeding is recommended immediately after cleft lip repair , the patients will experience less stress and crying , placing less tension on the wound than with alternative feeding methods .
Breastfeeding or bottle-feeding will result in more weight gain , facilitating wound healing