Feeding an infant born with a cleft

An infant born with a cleft of the lip and palate may have trouble feeding.  This is because the cleft in the palate prevents the baby from getting enough suction to draw milk from the breast or regular baby bottle. There are special bottles and methods for feeding a baby with a cleft.  During the first hours or days after birth, a feeding specialist will try various methods to find one that works for your baby.  There are several types of bottles and nipples that are made for feeding a baby born with a cleft.

Breast feeding an infant with a cleft palate is not usually successful.  You can try breast feeding. But we do not want you to feel like a failure if your infant cannot get enough food directly from your breast.  You can pump and feed breast milk to your child using one of the special bottles.

Babies born with cleft lip only can often breast feed or use a regular bottle and nipples sold in stores.  The baby might have a hard time keeping a seal on the nipple. Milk may dribble from the cleft side.  Try gently pressing the cleft lip against the nipple when feeding.

An infant born with a cleft palate (with or without a cleft lip) needs special care when learning how to feed.  The open palate makes it hard for the baby to create the suction necessary to draw milk out of the nipple and swallow.  It is also difficult for the baby to stop the flow in order to take a breath.

Because the mouth is open to the nasal passages, the baby will swallow air with every suck. The baby will need to be burped more frequently.    Watch your baby during the feed to find the pattern of suck, swallow and breathe that your baby is comfortable with.  You will learn to adjust your feeding strategy to match your baby’s pattern of suck, swallow and breathing.

We want the baby to finish a feeding in about 30 minutes.  When it takes longer, your baby may be working too hard and burning too many calories to grow.  If this is happens, another feeding method should be tried such as tube or syringe.

We recommend a feeding evaluation with our feeding specialist if there are problems with efficient feeds or if difficulty swallowing is observed.  The feeding evaluation will provide important information regarding the best way to feed your baby.