Feeding a child with a cleft

Nutrition is important for every newborn. Babies with a cleft lip and/or palate are special in that most will not be able to suck effectively, making feeding hard work for them.

• Ask to speak with a feeding specialist.
• Squeezable bottles can decrease the baby's work.
• Hold your baby in an upright position.
• Some milk may come out of the baby's nose. This is normal and will decrease over time. Keep a bulb syringe handy during feeding to help clear the baby's nose of milk, if needed.
• Burp after every 1/2 ounce. Babies with a cleft swallow a lot of air when feeding.
• Feedings should not last more than 30 minutes. Longer feedings tire the baby and waste calories. If necessary, feed more frequently (every two to three hours).
• Traditional breast-feeding may not be a successful option if the baby has a cleft palate. However pumping and providing breast milk through a bottle is encouraged.

As you and your baby get to know each other, feeding time will become easier for both of you.

Bottle and nipple options

There are several different bottles and nipples on the market that have been specifically designed for children born with clefts. When choosing feeding supplies, you may want to look for the following features:

• A soft, thin-walled nipple that compresses easily.
• A nipple that allows the milk to flow at a moderate pace, neither too fast nor too slow.
• A method that does not interfere with the normal swallowing mechanism or the normal activity of the oral-facial muscles.

Regardless of what combination nipple and bottle you choose, the goal is to make feeding easy for the baby while still allowing him or her ample opportunity to suck. Using a squeezable bottle is one way to increase the flow of milk and conserve the baby's energy. A few such bottles are the Mead Johnson Cleft Palate Nurser, the Pigeon Cleft Palate Nurser and the Haberman Feeder.

When using any squeezable bottle, the bottle should be gently pulsed, not continually squeezed. A squeeze only should be provided when the baby is sucking. Following the infant's own suck rhythm helps ensure that he or she does not aspirate milk into the lungs.

The Mead Johnson Cleft Palate Nurser is simply constructed and easy to use.

Both the Pigeon Cleft Palate Nurser and the Haberman Feeder need assembly and are a little more complicated to use. Many hospitals already stock Haberman Feeders since they also can be used to feed premature infants. Both are constructed to reduce the amount of air the baby swallows and have methods to control the rate of milk flow.