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Health Information For Parents
When a baby is born with a cleft, it’s important to help the baby feed well to prevent dehydration and make sure they gain weight. Babies born with a cleft may need some special feeding help.
Most babies born with a cleft lip (and no cleft palate) feed well without any special equipment. They usually can breastfeed or use a regular bottle-feeding system.
The only change needed might be positioning the nipple so the baby can latch. If you’re breastfeeding your baby, try changing the feeding position so that your breast fills the cleft.
Babies born with a cleft palate, whether with a cleft lip or without, can’t breastfeed. That’s because they can’t create the pressure needed to suck milk from the nipple. Trying to breastfeed or use a regular bottle system to feed a baby with a cleft palate can lead to poor weight gain and failure to thrive.
Other challenges include:
may have other feeding and digestive challenges.
Babies with a cleft palate need to be fed with a specialty bottle system. It provides the proper nutrition without the need for pressure while sucking.
Cleft feeding bottle systems include:
This bottle system has a one-way feeding valve that prevents milk from flowing back into the bottle. This lets the baby bite down on the nipple to get the milk without sucking. Different nipple flow rates vary based on the baby’s age (from preemie to level 3).
This bottle system often is the easiest for parents and caregivers. The baby does all the work and there’s no need for special positioning.
This bottle system also has a one-way valve to keep milk from going back into the bottle. The Y-cut nipple is thinner on one side and thicker on the other:
The nipple comes in two sizes. You also can adjust the flow rate by tightening or loosening the nipple.
This bottle system also has a one-way valve to keep milk in the nipple. Some babies can push the nipple against their gum to get the milk. But usually, a caregiver needs to squeeze the bottle to match the baby’s sucking and swallowing pace:
Getting the timing right can take a few tries. Three lines along the bottle show the nipple flow rate. Turn the bottle so one of the lines is under the baby’s nose to adjust the flow rate.
This bottle does not have a one-way valve. As with the Haberman bottle system, the caregiver must squeeze and time their pace to match the baby’s sucking pattern.
Feeding challenges put babies with a cleft palate at risk for failure to thrive. Regular weight checks by your baby’s doctor or the cleft team can help make sure your baby is gaining enough weight.
Sometimes babies fed with a specialty system still have feeding problems or trouble gaining weight. They might be uncomfortable during feeding and not get as much milk as they should. Signs to watch for include:
Change your feeding strategy if you see any of these signs from your baby. For instance:
If you have any concerns about your baby’s feeding, call your cleft and craniofacial team right away. The feeding therapist and/or nurse practitioner can check your baby during feeding. They can make changes to the feeding system or recommend other testing.
Feeding a baby with cleft lip/palate can be a challenge at first. But help is available. Look to the cleft team for support and information.
Many cleft teams offer prenatal consultations if an ultrasound finds the cleft before the baby is born. Parents meet with the team to ask questions, including any feeding questions. That way, a feeding plan is ready before the baby’s birth.
If the cleft is found at birth, the inpatient staff will help parents find a bottle system that works best for the baby. The baby’s doctor can refer the parents to a cleft team.
The cleft team usually meets with parents and their babies within the first week or two of life. They’ll see how feeding is going and answer any questions you have.
You also can find resources online at:
A cleft is when tissues of the mouth or lip don’t form properly when a baby is developing in the womb. The good news is that orofacial clefts are treatable.
A cleft lip is when a baby’s lip doesn’t form properly during pregnancy. Most kids can have surgery to repair one early in life.
A cleft palate is when a baby is born with a cleft (gap) in the roof of the mouth. Most kids can have surgery to repair them early in life.
A cleft palate with a cleft lip is when a baby’s lip and palate (roof of mouth) don’t form properly during pregnancy. Most kids with cleft lip and palate are treated successfully with no lasting problems.
In a submucous cleft palate, the muscles of the palate don’t form properly, but the tissue that lines the roof of the mouth does. This makes these clefts harder to see.
Speech-language pathologists help kids with speech problems related to a cleft palate. Find out what they do.
Most kids grow well but some have âfailure to thrive.â This means they don’t gain weight as expected and may not grow as tall as they should.
A prenatal ultrasound is a safe and painless test that shows a baby’s shape and position. It can be done in the first, second, or third trimester of pregnancy.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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