A longitudinal comparison of the psychological impact on mothers of neonatal and 3 month repair of cleft lip

SUMMARY.Purpose:This study investigates whether the timing after birth of babies’ cleft repairs influences the psychological status of mothers. Methods:Mothers of infants born with a cleft lip completed psychological assessments and semistructured interviews at four time points: 2–3 weeks, 3 months and 6 months following the birth. In addition, a preoperative assessment and interview was completed within the first week of birth for those with infants undergoing neonatal repair and within the week before surgery for the 3 month repair group. Results:There were no significant differences between mothers of infants with early (neonatal) and late (3 month) repairs on the emotional measures at any time point or preoperatively. Means of measures for anxiety and depressive symptoms and the Impact of Event Scale were within the normal range. Measures of interaction with the infant, perceived infant difficulty, bonding and parental competence failed to show any impact of timing of operation. Women’s emotional status improved significantly over the 6 month period regardless of operation timing. Qualitative analysis of interview data indicated most mothers preferred their infant to receive neonatal repair. Conclusions:There was no evidence to support the idea that repair neonatally or at 3 months led to differential levels of anxiety or depressive symptoms or differences in attachment to the infant. Nevertheless mothers expressed a preference for and greater satisfaction with neonatal repair. In the absence of definitive evidence of differences in physical outcome, parental preferences should routinely be considered in deciding the timing of this procedure.