Babies born with cleft lip and palate or isolate cleft palate are unable to drink milk directly from their mother’s breast or an ordinary baby bottle. This difficulty with feeding is caused by the opening (cleft) in the roof of the mouth (palate). The cleft in the palate connects the mouth and the nose making them one large cavity. This prevents the baby from creating suction to form a correct seal around the breast or bottle nipple to pull the milk out for drinking. Therefore, the baby needs to use a specialized bottle that does not require suction to deliver milk and formula. These bottle/nipples include the pigeon nipple, the Haberman Feeder and the cleft palate nurser models.
Ideally, you know the diagnosis of cleft lip and palate for your child before he/she is born. In this case I would have you meet one of our feeding specialists at Children’s Health before the birth of your child. Our Speech Therapists are our feeding specialists and they will provide you with feeding supplies, demonstrate the use of the bottles and provide education materials that will make your early attempts to feed your baby easier. Babies with a cleft palate and no other health issues can swallow normally and will gain weight normally when the appropriate feeder is used. We routinely perform weight check in the first few weeks of life to ensure that our patients with clefts of the lip and/or palate are gaining weight appropriately.
If you did not know your baby’s cleft diagnosis prenatally or were unable to meet a feeding specialists before delivery of your baby, I recommend that you have your child evaluated by members of the CMC cleft team within 1 week of being discharged from his/her birth hospital. The speech therapist will examine the size and location of the cleft and will watch your baby feed with the nipple/bottle you bring to the appointment. Feeding your baby should last 30 minutes or less so your baby can gain weight easily. Based upon the efficiency of feeding, they may try several models of feeder to decide which is best for your child’s needs.
There are many benefits of breast feeding and I encourage mothers to feed their babies breast milk. As I stated above, the cleft palate prevents latching because babies with cleft palate can not create suction in the mouth. When attempting to breast feed a baby with a cleft palate it may appear that they are latching and feeding but they will not be able to draw out milk well and will use a lot of energy in the process. This can make early attempts to breast feed a source of frustration and worry for mothers of a baby with cleft palate. We advocate breast pumping and using the breast milk in the specialized feeder that the speech therapist provides you. This approach allows for the most efficient feeding of breast milk, still provides all of the benefits of breast milk for the baby and the gives your baby the best chance of gaining weight normally.