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The effect of cleft lip and palate, and the timing of lip repair on mother-infant interactions and infant development.

Journal of Child Psychology and Psychiatry
Wiley Blackwell (Blackwell Publishing)
Publication Date
  • Adult
  • Age Factors
  • Case-Control Studies
  • Child Behavior Disorders
  • Child Development
  • Psychology: Cleft Lip
  • Psychology: Cleft Palate
  • Cognition
  • Female
  • Great Britain
  • Humans
  • Infant
  • Infant
  • Newborn
  • Longitudinal Studies
  • Male
  • Mother-Child Relations
  • Multivariate Analysis
  • Object Attachment
  • Regression Analysis
  • Single-Blind Method
  • Time Factors
  • Psychology


BACKGROUND: Children with cleft lip and palate are at risk for psychological problems. Difficulties in mother-child interactions may be relevant, and could be affected by the timing of lip repair. METHOD: We assessed cognitive development, behaviour problems, and attachment in 94 infants with cleft lip (with and without cleft palate) and 96 non-affected control infants at 18 months; mother-infant interactions were assessed at two, six and 12 months. Index infants received either 'early', neonatal, lip repair, or 'late' repair (3-4 months). RESULTS: Index infants did not differ from controls on measures of behaviour problems or attachment, regardless of timing of lip repair; however, infants having late lip repair performed worse on the Bayley Scales of Mental Development; the cognitive development of early repair infants was not impaired. Difficulties in early mother-infant interactions mediated the effects of late lip repair on infant cognitive outcome. CONCLUSIONS: Early interaction difficulties between mothers and infants having late repair of cleft lip are associated with poor cognitive functioning at 18 months. Interventions to facilitate mother-infant interactions prior to surgical lip repair should be explored.

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