Cleft Lip and Palate in Children

Feeding

There is no single/ best method of feeding your baby. The principles to follow are to:

1. Encourage your baby to learn normal reflexes such as sucking and swallowing
2. Treat your baby as normal as possible if there are no further medical complications requiring special attention/management
3. Prevent regurgitation

Typically, a combination of reflexes is used to achieve effective feeding. Two processes occur simultaneously. The first is the ability to create an adequate vacuum by creating a seal around the nipple/teat, and second, is the ability to position the tongue properly below the nipple.

Babies with a cleft usually have difficulty forming a good seal around the nipple to create a vacuum for suction. Fortunately, there are several ways of solving this problem:

1. Assisted squeezable bottles for feeding
2. Modified breastfeeding
3. Spoon feeding

Upon referral to the Cleft Team, the Plastic Specialty Nurse will meet you to assess your baby’s sucking and swallowing skills in order to determine the most suitable mode of feeding for your baby (e.g., positioning, type of bottle and teat).

It is important to position your baby at a 45 degree angle in an upright position while feeding to prevent choking or having fluid flow back up through the nose. During and after each feed, you are encouraged to burp your baby more often than a baby that does not have a cleft. This is because your baby may swallow more air than normal during feeding.

It is normal for a newborn baby to lose up to 10% of their body weight within the first week. This lost weight is usually regained within 2-3 weeks. Your baby is considered well fed if he/she has 6-8 wet nappies a day, has regular bowel movements and is healthy and alert.