Feeding a Baby with a Cleft
When a baby is born with a cleft, ensuring proper feeding is crucial to prevent dehydration and promote weight gain. Special feeding assistance may be needed for these babies.
Feeding a Baby with a Cleft Lip
Most babies with a cleft lip (without a cleft palate) can feed without special equipment. They can typically breastfeed or use regular bottles. Adjusting the nipple position might be necessary for a good latch. If breastfeeding, try different positions to fill the cleft with the breast.
Challenges of Feeding a Baby with a Cleft Palate
Babies with a cleft palate cannot create the suction needed to breastfeed, leading to issues like poor weight gain and failure to thrive. Other challenges include:
- Nasal regurgitation: Milk may leak out of the nose.
- Air swallowing: More air may be swallowed during feeding.
- Syndromes:Babies with additional syndromes may face other feeding and digestive challenges.
Bottle Systems for Feeding a Baby with a Cleft Palate
Specialty bottle systems are necessary for feeding babies with a cleft palate:
- Dr. Brown’s Specialty Feeding System: Features a one-way valve to prevent milk backflow, allowing the baby to bite down on the nipple to get milk without sucking. It has different nipple flow rates based on the baby’s age.
- Pigeon Feeder: Includes a one-way valve and a Y-cut nipple with a thicker side for the upper gum and a thinner side for the tongue. The flow rate can be adjusted by tightening or loosening the nipple.
- Medela SpecialNeeds Feeder (Haberman): Has a one-way valve and requires the caregiver to squeeze the bottle to match the baby’s sucking and swallowing pace. The flow rate is adjustable with three lines on the bottle.
- Enfamil Mead Johnson Cleft Lip/Palate Nurser: Does not have a one-way valve, requiring the caregiver to squeeze and time their pace to match the baby’s sucking.
Additional Tips for Feeding
- Feedings should take less than 30 minutes. If longer, use a faster flow nipple.
- Burp the baby every 5 minutes during the feed.
- Keep the baby upright during feeding and for 20–30 minutes after to reduce nasal regurgitation.
- Moms can provide breast milk through the bottle and offer non-nutritive sucking for comfort and bonding.
- Limit non-nutritive sucking to less than 10 minutes per feed.
Signs of Feeding Issues
Regular weight checks by a doctor or cleft team are essential. Signs of feeding problems include:
- Coughing during or after feeds
- Choking
- Watery eyes
- Furrowing eyebrows
- Back arching during feeds
Change feeding strategies if these signs appear, such as using a slower flow rate nipple or allowing more pauses during feeding. Contact the cleft and craniofacial team if you have concerns.
Parental Support
Feeding a baby with a cleft can be challenging, but help is available. Cleft teams offer prenatal consultations and post-birth support to develop and refine feeding plans. Resources like the American Cleft Palate-Craniofacial Association (ACPA) can provide additional information and assistance.