UKUFUNZA ISANA ELINOMPHARU ENDEBENI/ERHWALABHENI

ITLOLWE NGU GEORGIA HAITAS JAMMINE
Isazi seKulumo - iLimi 
Umtloli we ?Michael has a cleft lip and palate?
Uyilethelwa mNyango wezamaPhilo

NGO CHRISTOPHER

UChristopher, osencwadini ngaphandle, wabelethwa anompharu omasikizi okabili endebeni nerhwalabheni. Indebakhe yalungiswa lokha naneenyanga ezi-5 ubudala begodu koke kukhambe kuhle khulu. Irhwalabha lakhe lizakulungiswa ngemva komnyaka. 

Prof. L. Chait

NG0MTLOLI

UGeorgia Haitas-Jammine usisazi sekulumo-nelimi, esathoma ukusebenza solo kwangomyaka ka-1976, anekareko elikhethekileko emkhakheni wokuPharuka kweNdebe neRhwalabha. Utlole incwadi yabantwana ethi "Michael has a Cleft Lip and Palate"(Umichael unomPharu eNdebeni neRhwalabheni). Godu uyilektjhara kilomkhakha,  emNyangweni  wamaLwelwe wokuKhuluma newoKuzwa eYinivesity yeWitwatersrand.

? ?IKOMBA ??

INDLELA ISANA ELIJAYELEKILEKO LIGOMA NGAKHONA???2 
UKUMUNYISA IBELE  KULUNGANISWA NOKUMUNYISA IBHODLHOLO ????3
IMIRARO EKUHLANGABEZWANA NAYO EKUMUNYISENI ISANA ELIPHARUKE IRHWALABHA ?4
KUBAYINI UBUDE BESIKHATHI SOKUFUNZWA KWESANA BUQAKATHEKILE 5
UKUMUNYISA IBELE ISANA ELIPHARUKE IRHWALABHA ???5
UKUMUNYISA IBHODLHOLO ISANA ELIPHARUKE IRHWALABHA ???7
ISELULEKO ESIVAMILEKO SOKUMUNYISA IBHODLHOLO ????10
EZINYE IINDLELA ZOKUFUNZA EZINGABANDAKANYI UKUMUNYA ?10
UKUFUNZA NGEKOMITJI ???????11
UKUFUNZA NGESIRINJI NOFANA NGEDROPHA ?????11
UKUFUNZA NGEKHEZO ??????12
ITJHUBHU LEEMPUMULO NAMATHUMBU ??????12
UKUHLANZEKA KOMLOMO ???????12
OKUMAYELANA NOKHUNYE UKUFUNDA ??????13
OKUMAYELANA NESINYE ISELULEKO NESIZO ????13

Ukufunza isana 
elinendebe/irhwalabha epharukileko

NGO GEORGIA HAITAS JAMMINE
Isazi keseKulumo -neLimi 
Umtloli we ?Michael has a cleft lip and palate?

? ?ISINGENISO ??

Amasana abelethwe anerhwalabha epharukileko kanengi anemiraro yokufunzwa ngombana umgudu womlomo (umlomo) awukahlukani nomgudu weempumulo(iimpumulo).  Ngalokho-ke isana alikghoni ukudosa ngemlonyeni, ngikho liba nomraro wokumunya ibele namkha ibhodlholo.

Ubukhulu kanye nomhlobo wompharu okuba yinto ehlukako isana ngesana, ngibo obuqunta indlela isanelo elingafunzwa ngayo. Nakube isana linompharu endebeni kwaphela, umraro nakube uba khona uba mncani khulu nalifunzwako. Kukuba khona kwerhalabha elihlangeneko okuqakathekileko okwenza isana likghone ukumunya.

? ?INDLELA ISANA ELIJAYELEKILEKO LIFUNZWA NGAYO?

Indlela yokufunza ibandakanya ukusengelwa ekonweni (kungaba libhodlholo nofana amabele), isana libumba irorwana lebisi (ibholwana yebisi), bese irorwana yebisi leyo igedeka ukusuka ngaphambili iye ngemuva lomlomo lapha iginywa khona  iye ngendeni. Ngokujayelekileko isana likghona ukuphefumula ngeempumulo khibe lifunzeka ngomlomo. 

Lokha nakufakwa ikono ngemlonyeni, iindebe zenza itshidzo magegana nayo bese ilimu liyaphakama kobana ligandelele phezu kwerhwalabha eliqinileko. Ilimu lizabese liya emuva, linikele bona kube nesibanga esaneleko phakathi kweendebe nelimu/nerhwalabha ngaphandle kokungenisa ummoya ngemgudwini. Ngaleyondlela kuba nesikhala bese umkghado usengeleka ngemlonyeni. ?

Isikhala sivikela ikono bonyana ingaphumi emlonyeni begodu sivikela isana bona lisekele ukubamba kwalo ikono. Iinhlafunyo, ilimu, imihlathi neensini kugandelela umkghado kobana uphume ebeleni.

Indlela yokufunza iyafana kungakhethi bona ufunza ngani (ibele nofana ibhodlholo). Nanyana kunjalo indlela yokumunya  umkghado ebeleni iyehluka kunokudosa ibisi ebhodlholweni. Idemu yebhodlholo ayidingi umsebenzi omnengi esaneni ukusebenzisa iinhlafunyo, imisipha yobuso, ilimu, iinsini nemihlatjhana. 

? ?UKUMUNYISA IBELE KULINGANISWA NOKUMUNYISA IBHODLHOLO?

Ukutleleza kwebisi:
Ngokuvamileko, ukutleleza kwebisi ebhodlholweni kumsinyana kunebeleni , nanyana lokhu kuthintwa zizinto ezinengi eziphathekako, sib. umhlobo webhodlholo nekono, kanye nobukhulu bekono. ?Ukutleleza kwebisi nakufunzwako kuthintwa likghono lakamma lokwehlisa (ukukhupha ibisi) ngakelinye ihlangothi-ke umma wehlisa khulu nakube esana nalo limunye khulu. 

Ukumunyisa ibele kunemiphumela emihle :
a) Umkghado yinto evela emzimbeni, begodu ayithikamezi amathitjhu womzimba njengombana kwenza eminye imihlobo yokudla kwabantwana. Amathwethwesi wepumulo yesana elinompharu asepepeneneni, umkghado awuwathikamezi.
b)Ukumunyisa ibele akubangeli izinga elifanako lokugandeleleka maphakathi nendlebe njengombana kwenza ibhodlholo (kuba bubuhle ngombana amasana anerhwalabha elipharukileko abamsinyana ekuphathweni yimaphakathi yendlebe). Ukumunya msinyana kubanga ukulinganiseka kwegandelelo maphakathi nendlebe okuyinto enciphisa amathuba wokuphathwa yimaphakathi yendlebe.
c) Umkghado uneembulala mlwana. ?Unakho kokubili ilakthoferini ne-imiyunoglobhini okusiza ukuvikela ithelelwano. ?Amasana anompharu amunyiswa ibele anesibalo esiphasi khulu esibikwako sokuthelelwa mlwana. 

Ngaphandle kokuqala bona isana limunyiswa ibele namkha ibhodlholo, ikani nje kumele liphiwe ukudla okwaneleko. ?Ukumunya kunobubhadekelo ngombana kukhuthaza ukusetjenziswa kwemisipha yobuso edingeka malungana nokukhuluma okujayelekileko (ukuthuthukiswa komdumo). ?Ukudlula lapho, iindlela zokufunza umntwana osanda kubelethwa ziqakathekile. Umntwana ojayelekileko uthatha pheze imizuzu ema-20 ukuya kema-30 ukuqeda ukudla kwakhe, lokho kumnikela isikhathi esaneleko sokukhula kanye nokudla.

? ?IMIRARO EKUHLANGABEZWANA NAYO EKUMUNYISENI ISANA ELIPHARUKE IRHWALABHA ? ?

Imiraro kanengi ehlangabezwa masana apharuke irhwalabha ifaka hlangana:
? Ukumunya okubogabogako
? Ukukghanywa
? Ukutjokoza ngeempumulo (ukubuya kwebisi ngeempumulo)
? Ukufunzwa isikhathi eside
? Ukungabi nomzimba
? Ukuphefumula ngokwedluleleko

Esaneni elipharuke irhwalabha ukufunzwa okujayelekileko kuphazanyiswa kungakghoni ukumunye kuhle nobudisi okuhlangabezanwa nakho nakulingwa ukugandelela ikono. Amasana apharuke indebe kwaphela kanengi akabi nobudisi bokufunzwa.  Ukupharuka indebe nokho kuhazamisa ekwenzeni itshidzo magegana nekono. Lokhu kujanyiselela kukulokha isana nalisebenzisa itlobo yelimu nomqoqo wesini (ingcenye ekhukhumeleko yesini ebamba amazinyo) ukwenza ukuvaleka magegana nekono. ?Ukungabikho kwetshidzo/isivalo leso kungabanga bona ibisi livuze magegana nompharu. ?Nakubanjwa umpharu womntwana ngaphezulu namunyiswako noma ngakiliphi ibele kungasiza bonyana ibisi lingavuzi.  ?

Nokho, isana elinerhwalabha epharukileko alikwazi ukwenza itshidzo emuva emlonyeni ngombana umlomo nepumulo akukahlukani. Lokhu kumraro ngombana itshidzo eza muva edingeka nakumunywako ayenzeki. ?Ukuze kwenzeke itshidzo yamuva, kumele kube negandelelo ngemlonyeni elibanga bona kumunyeke.  Isana elipharuke irhwalabha ?nalilinga ukwakha indlela yokumunya sekufana nomuntu ovuthela ibhaloni epontjileko. ?Kanti-ke godu ngaphandle kokumunyokhu, isana alikwazi ukufumana ibisi ekonweni. Nangaphandle kokungakghoni ukwakha igandelelo elifunekako, nakube ikono ifakwa ngemlonyeni wesana, imisipha yokumunya izokwenza bona isana liphakamise ilimi lalo ukuze ligandelele ikono kobana iphume umkghado. ?Ukungabikho kwerhwalabha eqinileko kutjho bona ikono izokusunduzeleka  bunqopha ngaphakathi kompharu. Lokhu kubangela imiraro emibili. Kokuthoma, ikono igandeleleka kancani khulu phezu kwerhwalabha bese nakube kuyenzeka , uba mncani khulu umkghado ophumako kanti kwesibili, nakube ikono ingene ngempharwini bese kuphuma umkghado, uzodlulela ngeempumulweni kunobana uye ngemlonyeni bese ungena ngemgudwini wepumulo.  Ukudlulela komkghado ngeempumulweni kubanga bonyana unganeli umkghado oginywako bese kwenza bonyana ukumunyisa kuthathe isikhathi eside khulu. 

? ?KUBAYINI UBUDE BESIKHATHI SOKUFUNZWA KWESANA BUQAKATHEKILE ?

Ukufunda ukumunya kuyadinisa esaneni elinompharu, lingagcina sele lilele bese lingasamunya loke ibisi lalo.  Nakube isana aliseli ibisi elaneleko njalo nalifunzwako, angeze laba nobudisi obufunekako begodu lingagcina limteketekana. Lokhu kubangwa kukobana lokha isana nakuthathwa isikhathi phambi kobana lifunzwe lisebenzisa amandla amanengi kunangendlela lifanele lidle ngakhona. ?

Ngemva kokufunzwa kuvamisile kinofana ngiliphi isana kobana lilale. ?Ngesikhathi sokulala lesi, kanengi ukugayeka kokudla kuyehla bese kuvumela kobana isana lithele umzimba. ?Ngalokho-ke isana elinompharu liba nesikhathi eside sokungalali ngombana lithatha isikhathi eside nalidlako, le-ke ngenye imbambezela eyenza bona lingatheli umzimba ngokwaneleko. Ngalokho kuqakathekile bona ukudla kungadluli isikhathi sokudla esamukelekako (okungaba mizuzu ephakathi kwama-20 ukuya-30). ?

Nakube isikahthi sokudla sibonakala siluleka, ababelethi nabo bazithola babopheke isikhathi eside. Isikhathi esinengi esithathwa ekudleni, nokungabi nepumelelo, ngalokho kubanga bona ababelethi bahlanganelwe ziinhloko.

? ?UKUMUNYISA IBELE ISANA ELIPHARUKE IRHWALABHA?

Umhlobo wompharu uba nomphumela ekuphumeleleni ukumunyisa ibele. ?Ukumunyisa ibele isana elinompharu munye kungenzeka lula nakube ikono ifakwa ngehlangothini lomlomo elingakalimazeki. Isana kumele nalo liphathwe ngendlela ezakwenza bonyana ihlangothi elinompharu lihlala liqaliswe phezulu. Lokhu kuvikela bona ibisi lingachitheki emlonyeni okwenzeka nakube umpharu uqale phasi. 

Ukunciphisa ukungakghoni kuhle ukubamba nokumunya, umma angafaka ikono ngemlonyeni wesana abe aqede ukulimunyisa. ?Isisithakono nedemu zingasetjenziswa nazo.

Abomma kumele bakhuthazwe ukulinga ukufunza abantwana babaphethe ngeendlela ezahlukileko ukuze bakghone ukwazi bona ngikuphi okubasebenzela ngcono, isib. ukuphatha isana ngokulijamisa lilinganisane nekono. ?Lokhu kunciphisa ukutjokoza bese umkghado ungene ngeempumulweni ngombana kulitleleze lemvelo lomzimba, alithikamezi ithwethwesi lamathimila. 

Ukufunzwa okufaneleko akukameli ukuthatha imizuzu engaphezu kwema-30 begodu kumele kusungulwe iinkhathi zokumunyisa msinyana ngendlela okungakghoneka ngayo ngemva kokubeletha.  Umntwana angafunzwa kanenginengi kunesana elinganampharu, pheze njalo ngama-awara amathathu.

I-obtjhureyitha nayo inobubhadekelo. ?Lokhu sisetjenziswa esilungisa iinhlafunyo namazinyo, nofana ipleyiti esetjenziselwa ukuvala umpharu erhwalabheni eliqinileko. ?Lokhu kwenza bonyana ukufunza kube nomphumela omuhle emahlangothini amanengi. ?Abomma godu bangalinga ukubamba ibele ngemino bese bagandelela ngothubhakghuru ukuze umkghado utleleze.  Ukubeka ihloko yomuno phezu kwendebe enompharu kusiza ukwenza ukutshidzeka okungcono ukuze kuncanceke. 

Nokho kunobumbi obuthize ekumunyiseni isana elinerhwalabha epharukileko:
a) Isana lingahlulwa kubamba nokumunya, bese okukhambisana nalokhu kube kuhlulwa kugandelela ibele ngemlonyeni.
b) Umphumela walokhu kungaba kukuthi umma ugcina ahlangene ihloko kanti nesana liphele ihliziyo lilokhu litlhaga nokumunya. 
c) Izinga lokutleleza komkghado liba sidondi, bese kubange bona umntwana angadli kuhle. Ngalokho isana lingatheli umzimba. 
d) Nakumunyiswako kuba nzima ukutjho bona lingangani ibisi elimunyiweko belaginywa. Ukusebenzisa indlela yokusengela umkghado ngebhodlholweni iyawurarulula umraro lo. Qinisekisa bonyana umntwana uthambisa ileyiri lakhe ngendlela efaneleko. Lokhu kuqinisekisa bonyana akomeleli.
e) Abomma bangaphathwa kukomelela kwamabele nakube amasana akamunyi umkghado ngokwaneleko.

Ukusengela umkghado nokumunyisa ngebhodlholo elithambileko kwenza isana bona lizuze ekuseleni umkghado, kodwana ngaphandle kwemiraro yokumunyisa. 
Inakube ukumunyisa kuyaphumelela, kuyanelisa, nokho, nakube akusebenzi, umma usenganikelwa ithuba lokusengela bese amunyise ngeneye yeendlela ezitjhwiweko. Nanyana kufanele bona umma ahlale akhuthazwa ukulinga ukumunyisa, kanengi azakhe kuphumeleleke. 

? ?UKUMUNYISA IBHODLHOLO ISANA ELIPHARUKE IRHWALABHA?

Ukufunza ngebhodlholo kungcono kunangekhezo nofana ngetjhubhu lokudla ngombana kunikela umntwana ilwazi lokumunya, okuyinto eqakathekileko malungana nokuqina kwehlafunyo nokwazi ukukhuluma.  Njengombana ukumunyisa kanengi kuba budisi khulu, ukufunza ngebhodlholo kuba ngokho okunyulwako. Nakukghonekako,  kumele kusengelwe umkghado nebhodlholweni bese kumunyiswe umntwana.

Isana kumele liphathwe sakujanyiswa. ?Le-ke yindlela ejayeleke khulu nevumela bonyana namandla wedoselophasi atlelezisele ibisi  enzasi. Godu kusiza ukuvikela ibisi bona lingazali ngematjhubhuni weYustatjhiya nemaphakathini weendlebe. 

Kungcono nakube idemu iba ngeyeletheksi ethambileko kunobana ibe yisilikhoni. ?Idemu ingabiliswa kanenginengi ukwenzela bona ithambe.. ?Idemu ebanzi begodu espara efana ne- 'Nuk" nezinye ezibumbeke njengayo zinobubhadekelo esaneni elinompharu, begdu ithandwa khulu bosolwazi beenhlafunyo neensini (orthodontists). Omunye umhlobo wedemu enobubhadekelo yi- Pigeon latex, enetjhuba elinguncantathu. Nebhodlholo eligandelelwako nalo liyasiza kunalelo eliqinileko, ngombana ngalo ukghona ukusiza ukufaka ibisi emlonyeni wesana ngokuligandelela. 

Idemu ye-Pigeon Latex, ne-Nuk
Idemu enetjhuba elikhulu kunelijayelekileko nofana elenziwe sasiphambano ingasiza ukutlelezisa ibisi. Lokhu kungombana ukumunya kubudisi, yeke isana lidinwa masinyana. Nokho-ke itjhuba akukameli libe likhulukhulu kangangobana ibisi selirhutjhuke lokha ibhodlholo naliqaliswa phasi ngombana lokho kuzakwenza isana lirhitjhwe. Kungcono ibisi nalithonta kancani. Nawenza itjhuba elikhuludlwana sebenzisa inalidi etjhisako. Nawusika idemu sasiphambano, ihlanakele bese usika isiphambano  esingaba ma-5mm ukuvundla usebenzise utjhefana ohlazekileko. Nawuqedako uhlanulule idemu leyo-ke. 

Ukumunya kunzima esaneni elinompharu ngalokho isana lidinwa msinyana. Ukwenza bona ukufunzwa kube lula, kungasetjenziswa idemu enetjhuba elikhulu kunelijayelekileko nofana enetjhuba elisikwe sasiphambano ngombana isiza bona ibisi litleleze lula.  

Kungasetjenziswa nanyana ngiyiphi idemu ekhambisana nebhodlholo elisebenzisekako! ?Ukubona bona ukuhlanganiswa kwedemu nebhodlholo kuyasebenza isana kufuze likghone ukumunya kuhle, lithele nomzimba nawe uzizwe utjhaphulukile ngendlela limunya ngakhona. Nakube isana liyakghona ngedemu nebhodlholo elijayelekileko, khona-ke lisebenzise njalo nje. Nanyana ngikuphi okunyulako, kumele kube yinto etholakalako nethengekako. Nokho-ke kunendemu ezinengi ezenzelwe amasana anompharu. Lezo ezitholakele zinobuhadekelo ngeilezi:

I-Mead-Johnson Cleft Lip/Palate Nurser inamatshwayo alandelako:
? Ibhodlholo lenziwe ngeplastiki ethambileko negandelelekako, begodu linesibumbeko  'esiparaleleko' nofana esibuncande. Lokhu kwenza bona umfunzi akghone ukugandelela ibhodlholo ngokwaneleko ukusiza isana lidose ibisi elaneleko.
? Idemu yidanyana begodu imatsikazana kunejayelekileko, begodu isikwe sasiphambano ekugcineni. ?Ukusika sasiphambano akwenzi bona ibisi liphume nakube isana alilumalumi idemu nofana liyimunye. Ibisi liphuma kwaphela lokha isana nalilinga ukudla. ?Kwenzeka ukulinganela hlangana kokumunya kwesana nokugandelela komfunzi.
? Pheze nofana ngiyiphi idemu ingafakwa ebhodlholweni I-Mead-Johnson, nanyana ngasikhathi kuba nokuvuza kuya ngeendemu ezahlukileko, lokhu nokho akusiyinto etshwenya khulu, sekufuneka ibhibhi kwaphela.
? Amabhodlholo wakwa-Mead-Johnson ayatholakala eSewula Afrika,  nanyana kungasi sekhemisi oyijayeleko.** (Qala ikhasi 13)
? Ibhodlholo lakwa-Mead-Johnson lingasetjenziswa ngepumelelo emasaneni ane-Pierre Robin Sequence.
? Nanyana amabhodlholo wakwa-Mead-Johnson kuthiwa ?asetjenziswa kanye alahlwe? angahlanzwe bese kubulawa umlwana abuye asetjenziswe kanengingengi godu. Kungcono ungawafaki kumayikhroweyivi nofana emtjhinini ohlanza izitja. 

I-Haberman Feeder inamatshwayo alandelako:
? Idemu ede nethanbileko, ngokwayo emumatha itlelezi elima-29 ml.
? Ilinyana elisemlonyeni wedemu elingabekwa ngendlela yokobana lilawule ukutleleza kwebisi kobana lingaphumi, litleleze kancani, nokutleleza khulu.
? Idemu ethambileko ingagandelelwa kancani bese iyaliswa kobana ibhadekele imizamo yesana yokumunya.
? I-Haberman Feeder nayo sekhe yasetjenziswa ngepumelelo emasaneni ane-Pierre Robin Sequence.
? Umhlobo lo webhodlholo uyadura. Nawo uyatholakala eSewula Afrika nanyana ungatholakali emakhemisi ajayelekileko kodwana kubathengisi bemikhiqizo yakwa-Medela* (Qala ikhasi 13). Lokhu kuza kuhlangene, kuba libhodlholo, isivalo, idiski, ilinyana kanye nedemu.
? I-Haberman Feeder ayikalungeli abantwana abanobudisi bokuginya, okutjho labo abanobudisi bokukhambisa ibisi ukusuka emlonyeni ukwehlela emphinjeni.

? ISELULEKO ESIVAMILEKO SOKUMUNYISA IBHODLHOLO ?

Idemu kumele ifakwe ngemlonyeni wesana ukuze ihlale ngaphasi kwethambo lerhwalabha nofana phezu kwepleyiti lokufunza. ?Lokhu kwenza bona isana likghone ukugandelela ilimu lalo, nedemu, phezu kwethambo bese ngokwenza njalo lidose ibisi. Nakube idemu iphethwe yanqotjhiswa ngemlonyeni wesana, izokugandelelelwa ngempharwini bese ibisi litlelezela ngepumulweni lingayi ngemlonyeni.  ?

Njengombana isana lingaginya ummoya omnengi nalimunyako, kumele linonde libhodliswa, okutjho bona njalo nje emizuzwini embalwa. Nakube isana liyarhitjhwa, kumele kukhawulwe ukulifunza, libekwe phezu kwedolo lakho bese ulihlikihla ngetende yesandla sakho phakathi kwamahlombe. Wesule ibisi epumulwenalo. Nakube liragela phambili ngokurhitjhwa, kumele isana lifunzwe kancani kunekuthomeni, ibisi lingabethi ingemuva lomphimbo. Idemu enetjhuba elifana nalelo, ekhuphela ibisi ngemlonyeni ngasikhathi sinye, ingasetjenziswa ukuvikela ukurhitjhwa.

Kungaba yindlela esidondi, yeke kuqakathekile kobana ababelethi babekezele bazigedle, baziphe isikhathi esaneleko sokufunza. Kanengi ukufunza akukafaneli ukuba side ngaphezu kwemizuzu ema-30 ukuya e-45 njalo ema-awareni ama-3 ukuya ka-4. Isana kumele njalo nje liphathwe ngethando, lidlaliswe begodu likhulunyiswe. Lesi sikhathi esiqakatheke khulu sokusungula ubudlelwana obutjhideleneko phakathi kwakamma nesana. 

? ?EZINYE IINDLELA ZOKUFUNZA EZINGABANDAKANYI UKUMUNYA?

Ukuqakatheka kokumunya kugandelelwe, kodwana nakube ukumunyisa ibele nofana ibhodlholo akuphumeleli namkha udorhodera owanze i-ophareyitjhini empharwini athande bonyana kujame kancani ukufunza ngokusebenzisa iindlela ezimbilezi, kungasetjenziswa ezinye iindlela. Lokhu kufaka ukufunza ngekomitji, isirinji, ithunjana nofana ikhezwana.

? ?UKUFUNZA NGEKOMITJI ?

Ukufunza ngekomitji ngenye yeendlela ezilungileko zokujamiselela, ngombana iphephile, inepilo, ilula begodu itjhiphile, godu ingasetjenziswa ukufunza umkghado osengelweko. Sebenzisa ikomitjana  efana ne-40ml Baby Cup Feeder etholakala kubabi bemikhiqizo yakwa-Medela*. Hlanza ikomitji bewubulale imilwana bese uyibuyisa phakathi ngebisi. Beka isana phezu kwamathangakho, usekele ihlokwalo. Ungadinga bonyana uphuthele izandla zalo ukuze lingathinti ikomitji. Sondeza ikomitji eendebeni zalo zomlomo, kuthi nalivula umlomo, utjhigamise ikomitjhi leyo. Yeke lizokurhamula ibisi ekomitjini. Ungatheli ibisi ngemlonyenalo. Linikele isikhathi sokuphumula njalo ngemva kokurhamula. Lizaziselela ngesikhathi salo belilawule umthamo webisi eliwuthathako. Nasele lisuthi, lizokuvala umlomalo lingasafuna ukusela. Tjheja bonyana lisele umthamo ongangani ngelanga ingasi ekupheleni kokufunza okunye nokunye

? ?UKUFUNZA NGESIRINJI NOFANA NGEDROPHA?

Isirinji nofana idropha ingafunyanwa ekhemisi begodu ingasetjenziselwa ukuthontisela buthaka ibisi ngemhlathini womntwana kunobana liye emphinjeni. Ukusiza ngokufunza ngesirinji, kungananyathiselwa umuno weplastiki wokufunza wakwa-Medela* esirinjini. Ofunzako uzakufaka iminwakhe ngeqadi komuno wokufunza weplastiki bese uvumela isana limunye emunweni bese kancani kancani kugandelelwa isikhondo sesirinji.  Indlela le ingasetjenziswa ukuseza imithi. Umuno weplastiki wokufunza ngesirinji wakwaMedela.

? ?UKUFUNZA NGEKHEZO??

Ukufunza ngekhezo kubuthaka khulu, kodwana kungasetjenziswa njengejamiselela lokha ezinye iindlela nazihlulekilkeo. 

? ?ITJHUBHU LEEMPUMULO NAMATHUMBU*

Indlela le isetjenziswa njengemizamo yamaphelelo nakufunzwa umntwana onompharu. ?Kufakwa itjhubhu ngepumulweni yomntwana, bese linqotjhiswa kundinyana, ngalokho lidlula kuqhoqhoqho, ngaleyondlela ibisi lithelwa lehle ngetjhubhelo. Kuyindlela esidondi ngombana umntwana akubi nemizamo ayenzako, nokho kuyindlela ethembeke khulu yokwenza bona umntwana adle abe athele umzimba.  Kutuswa khulu bonyana akhuthazwe ukumunya idemu, isib, I-NUK Orthodontic dummy, khulukhulu nakufunzwako. Lokhu kuzokusiza imisipha yokumunya, okuqakatheke malungana nokukhula kwehlafunyo nokukhuluma. ?Godu lokhu kufundisa umntwana ukuthi athi nasamunyako, isisu sakhe sigcwale! Phezu kwalokho, isana kufanele liphathwe ngendlela ejayelekileko yokuphathwa nalifunzwako. Ngokujayelekileko ukufunza ngetjhubhu leempumulo nangethumbu kufanele kuliswe msinyana ngendlela okungakghoneka ngayo. 

? ?UKUHLANZEKA KOMLOMO??

Nanyana kusetjenziswa yiphi indlela yokufunza, kuqakathekile ukugcina zoke iindawo magegana nompharu zihlanzekile. Ngemva kokufunzwa kwesana, linikele amanzana abilisiweko apholiswa ngebhodlholo ukuze kusuke ukudla okusalele empharwini. Uboya obuthambisiweko nabo bungasetjenziswa ukuhlanza umpharu.  Nakube ukudla kusele kwaba kunengi, kuzokuhlangana neendende emlonyeni namathimila epumulweni bese kwenza ikhokho elomeleleko okungabanga ubulwelwe endawaneni leyo. Ilizwi lokugcina lokukhuthaza: Lokha isana nalithela umzimba, lizokhula begodu liqine, bese ekugcineni likghona ukusebenzisa nanyana ngiyiphi idemu nebhodlholo, nofana lisebenzise ikomitji. Akukaqakatheki ukuriyadisa ukulumula isana elinompharu kobana lithome ukugoma ukudla, kumele liphathwe njengamanye amasana ngendlela kungakghoneka ngayo. 

? Imikhiqizo yakwa-Medela iyatholakala kezinye iintolo ezikhethekileko zabantwana, emakhemisi ekhethiweko nemitholapilo ekhethekileko. Nakungasinjalo inga-odwa ngokusebenzisa abAbi bemikhiqizo yakwa-Medela: uJane Pitt ??at +27 11-788-9102/72. Imikhiqizo ingaposwa ngobusuku bunye enarheni yoke. 
?? Ukufumana imininingwana  eminye yokufumaneka kwe-Mead-Johnson Cleft Lip/Palate 
Nursers, thintana ne-Melrose Park Pharmacy at +27 11-887-8156/7.

? MAYELANA NOKUFUNDA NOKUFUNDA UKUYA PHAMBILI??

Arvedson, J.C. and Brodsky L.(2002) Pediatric Swallowing and Feeding: Assessment and Management (2nd Ed.) Singular Thomson Learning, Canada.

Miller, C.K. and Kummer, A.W.(2001) "Feeding Problems of Infants with Cleft Lip/Palate or Craniofacial Anomalies" in Kummer, A.W. Cleft Palate & Craniofacial Anomalies Singular Thompson Learning, Canada.

Sidoti, E.J. and Shprintzen, R.J. "Pediatric Care and Feeding of the Newborn with a Cleft" in Shprintzen, R.J. and Bardach, J. (1995) Cleft Palate Speech Management: A Multidisciplinary Approach Mosby, St. Louis.

? ?MAYELANA NEZINYE IZELULEKO NESIZO?.

? Itliniki nofana isibhedlela sangekhenu
? Isibhedlela sendawo yangekhenu
? I-inthanethi @ http//:www.cleftline.org or http//:www.widesmiles.com
? Ipope-O-Tshegel

Ngokuthokoza okukhulu abalungani bami uProf. Brenda Louw no Prof. Gerald Gavron ngesizo nangokusekela kwabo okukhulu, khulukhulu uNorman Pearce kanye ne- Netcare Marketing Team ngokuhlanganisa lokhu.
