General Feeding Tips for Parents-Cleft Lip/Palate

General Feeding Tips for Parents

By Claire K. Miller, PH.D.

RELAX
Most parents report feeling anxious about learning how to feed a baby with a cleft, but find the problems to be fewer than expected and easy to overcome when using the right type nipple, bottle, and technique.

FEEDING EQUIPMENT & METHODS
A particular method of feeding is usually recommended shortly after birth by a nurse, speech pathologist, or occupational therapist.  Try to use the adapted nipples, bottles, and feeding methods that are recommended, and be sure not to hesitate to call the nurse or speech pathologist if any questions arise about how to use them.

USING APPROPRIATE POSITIONING
Feeding a baby with a cleft palate in an upright position as opposed to the traditional cradle or reclined position will reduce the amount of liquid that can escape up from the nose during feeding.  Try to use a pillow or small foam wedge to support the baby against you in an upright position.

FEEDING REFUSAL
The baby may seem to be refusing to breast feed or bottle feed.  Try to problem solve what might be happening by considering the length of time between feedings.  If the feedings are too close together, the baby may not be hungry enough to be motivated to feed.

Consider the size of the nipple hole (is the baby working too hard to extract the fluid?).  This is a common problem.  Explore using a nipple that either has a faster flow rate or that is flexible enough for assistive squeezing.

If breast feeding, the baby may be overwhelmed with the initial milk let-down during feeding and demonstrate avoidance.  Experiment with hand expressing some milk before trying to breastfeed.

Experiment with the temperature of the formula if bottle feeding.  Although not proven by research, many infants seem to prefer warm formula as opposed to room temperature.

Try to be consistent with the method being used for feeding.  Train others who may be feeding the baby to use the same feeding equipment, and the same type of strategies you use when feeding your baby.  For example, demonstrate how to use assistive squeezing and how often you give the baby breaks for resting or burping during a feeding.

MANAGING AIR INTAKE DURING FEEDING
Babies with clefts will tend to swallow some extra air while feeding.  After intake of every ounce or so, giving the baby a pause from feeding and chance to burp may help to alleviate discomfort associated with excessive air intake.

PERSISTENT ORAL FEEDING PROBLEMS
Most feeding problems can be easily resolved.  If your baby continues to have trouble feeding and you are concerned, consult your pediatrician for a referral to a speech pathologist or occupational therapist experienced with the special feeding issues associated with cleft lip/palate or other craniofacial anomalies.

Information cited : Kummer, A. 2008, Cleft Palate and Craniofacial anomolies:Effects on speech and resonance,  Delmar: Clifton Park, New York.