Feeding

Feeding your baby
Full term babies are born with a natural ability to feed and this applies to most babies born with a cleft. You may have already have planned how you would like to feed your baby. Your midwife and Clinical Nurse Specialist will support you in your choice.

In order to feed, new-born babies suck swallow and breathe in a smooth and coordinated way. Suction is important in both breast and bottle feeding. For babies born with a cleft, the gaps in the lip or palate may make it difficult to create a seal and maintain suction. To help your baby to feed, special bottles and teats may be necessary along with some adjustments in technique.
Breast milk is the natural milk for your baby and can be less irritating to the fragile nasal linings of babies born with a cleft palate. Breast milk also helps protect babies against stomach upsets, ear and chest infections, diabetes and eczema whilst encouraging general development and growth.
Alternatively, you may decide to offer your baby a standard infant formula of your choice.
For babies born with a cleft involving the palate, feeding directly from the breast will be more difficult and you may need to express your milk. This can also be the case for babies with a cleft lip only. An exaggerated latch onto the breast may be possible and will be demonstrated to you by your midwife or Clinical Nurse Specialist if deemed appropriate. During the first few days putting the baby to the breast can help establish the flow of milk. You will be offered the loan of an electric breast pump at no cost to yourself for as long as you wish to express milk for a maximum of a year following the birth of your baby.

Specialist feeding equipment
For babies born with a cleft palate/ cleft lip and palate, and occasionally a cleft lip only, it may be necessary to offer expressed breast milk or infant formula from a cup, syringe, scoop or soft bottle. The soft bottle allows you to give your baby the milk by gently squeezing the sides as he/she suckles. A larger orthodontic latex teat is also often required. The teat sits across the cleft in the palate preventing the teat from moving up into the delicate tissue of the nose thus preventing ulcers.
It maybe that your baby is unable to use a soft bottle during the first few weeks following birth but your clinical nurse specialist will assess your baby’s skills and make a plan with you
Your clinical nurse specialist will provide your first supply of feeding equipment. Extra feeding bottles and teats can be purchased from CLAPA (Cleft Lip and Palate Association).

What happens if my baby unable to feed.
Occasionally, new-born babies are unable to feed at the breast or from a bottle. An assessment of feeding skills is undertaken by the Clinical Nurse Specialist soon after your baby is born and will be repeated as your baby develops and changes. It is important that all babies are given the opportunity to develop feeding skills as they grow. Some babies will require the support of special high calorie milks or a feeding tube to obtain enough nourishment to develop. Your Clinical Nurse Specialist will discuss all the options available to help your baby grow and thrive.

When will I be able to feed my baby with an ordinary bottle?
After your baby has recovered from surgery to close the palate, you may be advised to stop using the soft bottle and encourage your baby to start making use of the muscles of the newly repaired palate. This may take several weeks.

What happens to feeding at the time of surgery?
We encourage babies to feed as soon as they are awake and alert enough after the anaesthetic. It may take a week or two for the baby to get used to the repaired lip or palate but this rarely causes any long term problems.

Are there any other things I should look out for?
Babies with a cleft lip sometimes experience dry lips and gums. If this happens, simply apply a small amount of petroleum jelly or nipple cream to the area with your finger.
Small amounts of cooled boiled water following a milk feed will help to keep your babies mouth clean where there is a cleft of the palate. This is especially important if your baby experiences frequent nasal regurgitation of milk and if formula fed. Extra water is often not necessary if your baby is having breast milk.
If your baby has a cleft palate, a white area may appear on the central part of the roof of the mouth during the first few weeks. This is usually painless and disappears quickly. It is important to place the teat well into your baby’s mouth on the centre of the tongue. Try to keep the teat still in your baby’s mouth no matter how tempting it may be to move it around to stimulate your baby to suck.

Who will be available to help me?
When you go home from the maternity unit your Clinical Nurse Specialist will visit you on a regular basis and provide support until after your baby’s operation(s). As your child grows up, you may contact your Nurse for further help by telephone or during clinic visits.