As a result, the vast majority of mothers of babies with RS are unable to breastfeed, and alternative feeding techniques often result in inadequate nutrient intake, so that reported rates of poor feeding in infants with RS range from 47 to 100%. It often also prevents achieving a sufficient oral vacuum for adequate sucking. In cleft palate, which is present in 80–90% of RS infants, severity and size of the cleft usually correspond to the degree of feeding difficulties, because the wider the cleft palate, the smaller the area available for serving as an abutment for the nipple. For example, glossoptosis may prevent placing the nipple on the body of the tongue during feeding, which together with mandibular micrognathia and an upper-lower jaw discrepancy may inhibit development of an efficient sucking pattern. UAO results in an elevated energy expenditure due to an increased work of breathing, which is the main cause of growth failure in RS, being further aggravated by feeding difficulties resulting from the characteristic anatomy. For several reasons, it also often leads to growth failure. Robin sequence (RS), consisting of mandibular retrognathia, glossoptosis, upper airway obstruction (UAO) and optionally cleft palate, has an estimated birth prevalence of 1:8500–1:14,000. As RS infants often show postnatal growth failure, weight monitoring may be a valuable parameter for monitoring treatment effectiveness.Ĭlinical Trial Registration Not necessary due to the retrospective design. Conclusionīased on a comparatively large cohort, this functional treatment was associated with better weight gain and improved feeding. Z-score subsequently increased from − 1.17 at discharge to − 0.44 at the 1-year follow-up ( p < 0.001). Z-score then remained largely unchanged until discharge (Z-score difference, − 0.08), while the proportion of infants receiving tube feedings decreased from 55.1 to 13.7%. In 307 infants analyzed, median Z-score for weight decreased from − 0.28 at birth to − 1.12 upon admission to our center at a median age of 22 days. Through our electronic patient database, we evaluated anthropometric parameters until reaching 1-year follow-up. This retrospective study analyzed longitudinal data from infants with isolated RS admitted to Tuebingen University Children’s Hospital, Germany between 19. To investigate the effect of the Tuebingen treatment protocol on growth and weight trajectories during infancy. A functional treatment concept, used in our center for > 20 years, includes a pre-epiglottic baton plate (Tuebingen palatal plate) and intensive feeding training. Various conservative and surgical treatment approaches exist, but their impact on weight gain has not yet been adequately addressed. Children with Robin sequence (RS) are at risk of growth failure, mainly due to their increased work of breathing and feeding difficulties.
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