A baby with a cleft lip/cleft palate often has to be bottle fed, rather than breast fed (Green, 1997). The baby often has difficulty feeding without special help, and the parents can become frustrated (Green, 1997). The ease of breastfeeding or bottle feeding depends on the infant's ability to generate effective oral suction by negative pressure (Dalben, Costa, Gomide, & Neves, 2003). Often parents are wanting to breastfed, but cannot and must resort to bottle feeding, via breast pumps or formula (Dalben, Costa, Gomide, & Neves, 2003).

 

Cleft Lip Babies?

 

Usually, parents have no major problems feeding a cleft lip infant (Johansson & Ringsberg, 2004). 

 

Babies with cleft lips can often breast feed (Green, 1997).

Cleft Palate Babies?

Feeding a baby with a cleft palate can be difficult and challenging (Green, 1997).

Babies with cleft palate are most often not breastfed because they cannot form a seal or suction on the mother's breast and they do not have the mechanical ability (Green, 1997).

This is dependant on the size of the cleft palate; those with a very small cleft palate may be able to create enough negative pressure to be successful at breastfeeding (Dalben, Costa, Gomide, & Neves, 2003).  

Many mothers often use a breast pump and bottle feed a baby with a cleft palate. If the cleft is large a special teat is recommended (Johansson & Ringsberg, 2004).

Other methods include spoon or cup feeding (Johansson & Ringsberg, 2004).

Positioning The Baby While Bottle Feeding?

Position the baby is a 'semi-upright' position. This helps the milk flow downward into the baby’s stomach. This also minimizes milk from washing up and flowing into the babies nasal passages or into the estation tubes (Green, 1997).

Avoid feeding the baby in a 'reclining position'.  Remember that you want to keep the head higher than the stomach (Green, 1997).

What type of bottle is used?

A popular nurser for clefts is the "Mead Johnson Cleft Palate Nurser." This is because it is made of soft squeezable plastic, and has an oblong/flattened shape (Green, 1997). This allows the bottle to be squeezed and deliver food to the baby who cannot form a seal. A suck/swallow rhythm needs to be developed when squeezing the bottle for proper feeding to occur (Green, 1997). The nipple is longer than regular nipples and the tip is cross-cut (Green, 1997). Other alternatives are to use a preemie or orthodontic nipple while bottle feeding (Green, 1997).

Burping?

Keep in mind that a baby with a cleft will often swallow more air during a feeding (Green, 1997). Therefore, frequent burping is necessary. This will help reduce the amount that is spit-up (Green, 1997).