After any baby’s birth, providing proper nutrition is a primary concern, for both parents and health care professionals. But for the parents of children with orofacial clefts, the prospect and practice of feeding brings a unique set of worries and potential difficulties.
Discuss proper feeding techniques with members of your orofacial cleft team to decide on the best strategies for your own child. Each baby’s needs will be different, depending on the placement and size of their clefts.
Tips For Feeding Your Baby With A Cleft Palate
With an opening in the mouth’s roof, babies born with cleft palate, as well as those with cleft lip and palate, have trouble creating adequate suction because air is leaking from the mouth upwards into the nose.
Most babies with cleft palate find it difficult to breastfeed, and tire quickly because they’re working so hard to extract milk.
Breast feeding works best for babies with small, narrow clefts. You should try to direct your nipple towards a portion of the palate that is not separated, then let your baby get a good grip on the breast and massage it from underneath with his or her tongue.
Breast feeding babies with cleft palates is easiest if you have a strong flow of milk, and you can try massaging your breast beforehand to encourage the flow along.
Many lactation consultants recommend limiting breastfeeding sessions to ten minutes, and then supplementing a child’s nutrition with bottles. Mothers usually begin breast pumping while still in the hospital, so that their babies have enough milk on-hand.
Children with cleft palates usually have trouble creating adequate suction on any nipple, and most benefit from special bottles designed to allow for increased flow.
Expect feedings to be a learning process. You and your baby will have to find the right positions together, and it might take longer individual feeding sessions than you were expecting.
Finding The Right Position
First, try holding your baby upright. Your child can either sit on your hips facing out or you can cradle, using the crook of your elbow as a shelf to support the head. The idea is to align your baby’s head and neck with their shoulders, in a straight line, but some children feed more effectively with their chins tilted towards the chest.
The upright position won’t eliminate the possibility of milk flowing through the cleft, but it should limit the amount that does. If your baby’s head tilts too far back, use a rolled up towel to support it against your elbow.
Learning To Suck
You’ll probably have to tickle your baby’s lips first so they know it’s time to feed. Once they turn to the nipple, and open their mouth, place the nipple on their tongue. Tilt the nipple down, away from the cleft. Your baby will learn to move it themselves into a comfortable position. Keep the bottle angled down so the tip is always filled with milk.
Babies have to learn to swallow after sucking; they aren’t born knowing that a succession of quick sucks will fill their mouths with too much milk. Within a few days, most children figure this out, but listen for a suck, followed by a swallow and a breath to make sure.
Milk Through The Nose?
If some milk escapes through your baby’s nose, don’t worry – it’s common and not dangerous. Your child is not choking. Tilt your baby into a more upright position. There are little bulb syringes that you can use to suck some of the milk out, but finding the right position is more important.
Sneezing and coughing are actually good, because they clear the nasal passages. Keep a bib or towel handy to clean up any drainage.
How Long Should Feeding Take?
Around thirty minutes or less. Longer stretches of feeding are tiring, and can actually burn more calories than your baby needs to consume.
Your baby should remain calm throughout the feeding process. She will tell you when she is uncomfortable and needs to burp. Babies with cleft palate burp more frequently, because they’re swallowing more air. Follow your child’s lead.
How Do I Know If It’s Working?
Ask your primary care physician how much milk your baby should consume in a day. Usually, the guidelines call for around two to three ounces each feeding and six to eight feedings every day.
Babies normally lose weight during the first week of life, and then steadily regain it until reaching their birth weights. If your baby is getting adequate nourishment, she should meet that birth weight around two weeks.
Feeding Your Child With An Isolated Cleft Lip
Babies with isolated cleft lips, on the other hand, usually have little trouble creating suction around a nipple, although some parents find it helpful to manually close the separation and create a tight seal that way. For other babies, it’s enough to block the gap with breast tissue.