Cleft Lip and Palate Program

Feeding Difficulties with Cleft Lip and Palate

Frequently, the most immediate concern for a baby with a cleft palate is proper nutrition. Sucking is difficult for a child with cleft palate because most times the baby cannot create enough suction to pull milk from a standard bottle or the breast. The baby may appear to be working very hard at feeding, but end up taking only a very small amount of breastmilk or formula. When this happens, the baby does not gain weight properly and may require readmission to the hospital.

Issues of extra air intake and nasal regurgitation (milk coming from the nose) may also occur. With proper teaching, support and patience, most babies with cleft palate go on to do very well with feeding. In some cases, extra support from a feeding team may be recommended.

Children with cleft lip but without cleft palate do not usually have feeding difficulties.

Can I breastfeed my baby with a cleft palate?

In the presence of a cleft palate, breastfeeding in the traditional manner is often not recommended, but there are alternative methods for providing breastmilk to your baby. Pumping breastmilk and using specialty bottles are supported as a way of feeding a baby with a cleft palate. The Breastfeeding and Lactation Program at CHOP, or a local lactation consultant, may be of great benefit to you and your baby as you attempt to establish good feeding behaviors.

Which bottle is right for my baby?

Finding the right bottle for your baby can be a challenge whether a cleft of the palate is present or not. A variety of bottles exist for this very reason. Work with your delivering hospital for specialty bottle recommendations at the time of delivery. If a change is needed once we see your baby, we will guide you in that change.

Some examples of specialty bottles include:

More tips for feeding a baby with a cleft palate

The following are some suggestions to help feed your baby with cleft palate:

  1. Observe your infant for a period of sucking, followed by a swallow and a brief period of breathing. Do not squeeze the bottle during the swallowing or breathing phase.
  2. Keep the bottle tilted so the nipple is always full of milk. This may mean using smaller infant feeders in the beginning.
  3. Expect the possibility of milk coming out of the nose along, with some sneezing or coughing. This is not choking. Allow your baby to clear this on their own with observation.
  4. Babies with cleft palate should be burped more frequently, but not so often as to interrupt good feeding behaviors.

Choice of formula, management of medical issues, and well-baby care remains at the direction of your pediatrician. Our team is available to support you and your pediatrician when it comes to the specialized techniques needed in feeding a baby with a cleft palate.

The Cleft Palate Foundation offers additional helpful information regarding the care of a child with a cleft lip and/or palate.

 

July 2013

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