Feeding an Infant with a Cleft Lip/Palate

- Anne Lueck, Ph.D., CCC-SLP

Feeding the newborn infant with a cleft can be a frustrating experience for hospital personnel as well as parents. Births of babies with clefts are relatively rare so nursery personnel have few opportunities to become comfortable with the feeding process. The awkwardness and uncertainty experienced by the hospital staff are often transmitted to parents thus increasing the parents' own fears that they will not be able to feed their baby successfully. The following are a few suggestions to facilitate the feeding process.

  • Approach feeding with the attitude that the baby will feed successfully and the similarities in this little human being to his peers far outweigh the differences. In other words, approach him as normally as possible!
  • Relax and assume a comfortable, cuddling posture with the baby in a semi-sitting position. Allowing the baby to lie back in your arms causes milk to run back into the eustachian tubes and produces ear infections. The semi-sitting position takes advantage of gravity and keeps the ears free of milk.
  • Remember that the infant with a cleft of the palate cannot build up suction in the mouth, so suckling requires external control of the flow of milk. Ways to help with this are to hold the chin up with the little finger and/or to apply pressure to the cheeks. This helps the child to maintain suction.
  • Select a feeder that is as "normal-looking" as possible. Parents often react negatively to syringes, hummingbird nipples, and other unusual devices because they are awkward and attract negative attention from onlookers. Mead-Johnson has a soft bottle that accepts any nipple type and allows mom/dad to aid with flow decreasing the needs of the child. This bottle and nipple look "normal"
  • Remember that feeding his or her infant is extremely important to parents in the bonding process. "Normal looking" and "normal feeling" facilitate bonding.
  • Feeding an infant with a cleft takes longer than feeding other infants but never feed for more than 30 minutes at one sitting or less than 30 minutes at one sitting. The baby begins to use more calories than he or she gains after that point.
  • Be patient with yourself and the parents. Take your time. Watch the parents feed several times before sending them home.
  • Some babies with a cleft can be successfully breast-fed. If this is important to the parents, they can facilitate at least the use of pumped breast milk or use a bottle nipple over the mother's nipple.

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