In this section
Babies spend much of their
time feeding. To feed well, they need to position their lips
and tongue around the nipple or artificial teat, and create both
suction and compression during sucking.
Sucking is more difficult when a baby is born with a
cleft palate or combined cleft lip and cleft palate. There are a number of ways to help these babies
Babies born with a cleft
lip alone usually feed well. Some babies breastfeed better with the
cleft facing upwards. The breast tissue usually fills the gap where
the cleft is and allows efficient feeding. Some bottle fed babies
feed better on a wide based teat.
Babies with cleft palate
often look like they are feeding well because the lips and tongue
close around the nipple or artificial teat like non-cleft babies
and the jaw moves well during sucking.
But most babies with cleft
palate cannot generate suction during feeding. The lack of suction
makes it difficult, and for some babies impossible, to breastfeed or
drink from a bottle efficiently. Consequently, feeding can take a long time
and is tiring for the baby who may not get enough milk to grow and
develop well. Help is available to manage these feeding
Babies with cleft palate
can't create enough suction during feeding to draw milk from the
breast or bottle easily. This is because air leaks from the mouth
through the cleft into the nose during feeding. If the baby also
has a cleft lip he/she may not be able to compress the breast or
teat well enough to push milk from the breast or bottle.
In either case, feeding is
usually slow and tiring and the baby may not drink enough to grow
well. These problems are usually solved by using teats and bottles
especially designed for babies with cleft palate. Your cleft
coordinator can show you the different bottles and teats available
and demonstrate how to use them.
You can buy this equipment
Breastmilk is best for
babies. When babies can't feed well directly from the breast, mothers may choose to feed their baby expressed breastmilk (EBM) from a
bottle. Lactation consultants and Maternal and Child Health Nurses are able to provide specific advice and support to new
mothers who wish to express breastmilk for their baby.
There is no need to use the equipment described below if your baby feeds well
from a standard teat or bottle bought from a supermarket or
A number of special teats
and bottles are available for babies who cannot generate suction
and/or compression during feeding. They come in different
shapes and sizes and have several features in common.
Each baby is unique so
different techniques will suit different babies even if they have
the same kind of cleft. However, some general tips are:
Your plastic surgeon will
give specific instructions on how to feed your child in the first
few days after the surgery to repair the lip or palate. In
general, babies are encouraged to return to their usual method of
feeding (breastfeeding or bottle feeding) after surgery. If
the baby has progressed to solids, these can also be
reintroduced quite quickly after palate repair surgery. The food should be a soft, 'sloppy' consistency for the
first three weeks.
Babies with cleft palate or cleft lip and
palate usually start taking solids at the same time as other babies
(usually around six months).
Sometimes food may come out through the
baby's nose during feeding. This may improve if you sit your baby more
upright or make the food a little runnier. If problems persist, you
can contact the speech pathologists for advice.
You can get bottles and teats from The Royal
Children's Hospital Equipment Distribution Centre or
CleftPaLS. Contact details for both are listed below.
Produced by the
Department of Speech Pathology in consultation with the Department
of Plastic and Maxillofacial Surgery at the Royal Children's
Hospital. First upload: May 2005. Updated October