Feeding a child with a cleft

At Children's Wisconsin, we know how difficult it can be to feed your child who has a cleft lip or palate, and we're here to help. Although each child is different, there are some tips that may help you help your child.

Please note: The following is general information and does not replace the instructions of a doctor or nurse who has seen your baby.

Nutrition is important for every newborn. Babies with a cleft lip and/or palate may have difficulty sucking. Eating may be hard work for them and feeding them may be hard work for you.

Feeding tips

If you have any concerns about feeding your child:

• Ask to speak with a cleft nurse or feeding specialist.
• Try using squeezable bottles. They can decrease the work your baby needs to do to get enough food.
• Hold your baby in an upright position when feeding.
• Don't be alarmed if some milk comes out of your baby's nose. This is normal and it will decrease over time. Keep a bulb syringe handy during feeding to help clear your baby's nose of milk if needed.
• Burp your baby after every half-ounce. Babies with a cleft swallow a lot of air when feeding and require more frequent burping.
• Understand that feedings should not last more than 30 minutes. If you feed your child for longer periods, it can tire your baby and waste calories. If necessary, feed more frequently (every two to three hours).
• Traditional breastfeeding may not be a successful option if your baby has a cleft palate. However, we encourage you to pump and provide breast milk through a bottle whenever possible.

Although it can be frustrating at first, know that as you and your baby get to know each other, feeding time will become easier for both of you. If you have any questions or concerns, talk with your child's doctor or to a lactation (nursing) consultant.

Bottle and nipple options

There are several different bottles and nipples on the market that are 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

Squeeze bottles

Regardless of what combination nipple and bottle you choose, the goal is to make feeding easy for your 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 your baby's energy. A few such bottles are:

• The Mead Johnson Cleft Palate Nurser
• The Haberman Feeder
• The Pigeon Cleft Palate Nurser

When you use any squeezable bottle, you should gently pulse the bottle rather than continually squeezing it. You should only provide a squeeze when the baby is sucking. Following your child’s own sucking rhythm helps ensure that he or she does not aspirate milk into the lungs.

Which bottles are best?

Experience has taught us that, even of the bottles we recommend, some are easier than others.

• 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 babies swallow, and both have methods to control the rate of milk flow.

Call with questions

If you have questions or concerns, call the Cleft nurse clinician at (414) 266-2575.