FEEDING THE INFANT BORN
WITH A CLEFT

The first problem to be addressed by the mother of the newborn infant is how to feed her baby. Feeding should not only provide the necessary nutrition, but should also be a pleasurable experience for the infant as well as for the mother and will help in strengthening the bond between the mother and infant.
Most infants born with clefts should be able to breastfeed. Unquestionably mothers' milk provides not only the best possible nutrition but also substances that will help him remain healthy until he can build up his own immune system. Infants born with cleft lip should not have significant problems breastfeeding, while infants with cleft palate or cleft lip and palate may experience initially some difficulty, because they lack the ability to generate the negative pressure that is necessary to create effective suction. As a result, they may experience fatigue and consequently not be able to take the necessary quantity of milk. They may also swallow large amounts of air resulting in excessive burping or vomiting. Should this be the case, they will not gain weight in a satisfactory rate, and the parents should seek medical help without delay.
When a baby breastfeeds the nipple and areola (the dark area around the nipple) should be positioned in such a way that the gap in the area of the cleft will be blocked by this part of the breast. Occasionally, pressing the area of the areola with the fingers might help the milk flow. Preliminary massage of the breast may also help by facilitating the concentration of milk in the area of the nipple. If despite the initial attempts to adjust difficulties continue to exist, it might be advisable to pump the milk using the special breast pump and give it to the infant with the feeding bottle.
In those cases when the child cannot breastfeed and has to take either maternal milk or feeding formula from the bottle, the feeding nipple has to be soft. Nipples can be rendered softer by boiling. Cross-cutting the nipple with a scissors will enlarge the opening and increase the flow of milk or feeding formula, and reduce the suction effort. The use of plastic squeezable bottles will also help increase the flow and facilitate feeding. The parents should, in most cases, quite quickly become familiar with feeding techniques and will be comforted by noticing that their infant is gaining weight at a satisfactory rate.