Feeding the Newborn with Cleft Lip and Palate

Good nutrition is important for the growth and development of your baby. Some babies with cleft lip and palate are able to be fed with a bottle and later a spoon without problems, but others have a hard time. The cleft makes it difficult for the baby to get good suction on a bottle. While sucking and swallowing reflexes are present in a baby with cleft lip and palate, they do not work right. Your baby may not get enough to eat, or may get too tired when eating. Sometimes babies have problems with food coming out of the nose. The baby may choke, cough, and spit. The goal of feeding your baby is to lessen these problems and ensure good weight gain.

Feeding Suggestions

Position:

Holding the baby in an almost sitting position (not lying down) can help make feeding easier.

Nipple Selection:

The nipple should be easily compressed. Examples are any "early" nipple (birth to three months,), an "orthodontic" nipple, a "preemie" nipple, or a "newborn nuk nipple." A slow steady drip should come out of the hole in the nipple when the bottle is upside down. If not, it can be cross cut or enlarged. The goal is to feed slowly enough not to choke the baby, but fast enough not to tire the baby out.

Directing Flow:

The flow of formula should be directed to the side or back of the baby's mouth.

Bottle Selection:

The baby may feed well with a regular bottle, but may need a bottle that can be squeezed, such as the "Mead Johnson nurser".

Burping:

Because of the cleft, your baby swallows air while feeding. So the baby should be burped frequently, after every ounce of formula.

Timing of Feeding:

Your baby may need small, frequent feedings. In general feeding should not take more the forty five minutes. If your baby takes forty minutes or longer to finish a feeding, decrease the time between feedings.

Cleaning of the mouth:

Follow feedings with little bit of water to cleanse the inside of the mouth. If you notice formula sitting in the baby's mouth, you can use a bulb syringe to remove it, or gently wipe it away with a piece of gauze.

When to Call:

Call if the baby has signs of dehydration such as dry skin, a sunken soft spot, or no wet diapers for six to eight hours. Call if the baby has feeding difficulties such as taking longer than one hour to finish a feeding, or a lot of choking or gagging. Call if the baby shows signs of tiring while eating such as falling asleep.

Return to Clinic:

You will be given an appointment to the Plastic Surgery clinic. There, you will see the Speech Language Pathologist who specializes in the feeding of babies with cleft lip and palate.