The first thing to note is that many children with clefts feed without difficulty and problems will not automatically arise because of a cleft.
That said, a baby with a cleft palate is more likely to have a feeding difficulty because, without a properly functioning palate, your baby will find it difficult to gain and maintain suction of the mouth. Your baby may tire more quickly from the effort of trying to maintain suction. Your baby may also experience problems of liquid coming down the nose.
Following palatal repair, your baby may again experience feeding difficulties. Feeding patterns pre- and post-operative should be checked with the hospital where surgery is due to take place.
It is important to remember that aside from the mechanical difficulty of the cleft your child is like any other baby and, given some help and direction, you can develop a workable feeding pattern. If your child is having difficulty it is important to acknowledge that the fault lies with the cleft, not with your child or with you.
If your baby is having problems you should get in touch with a speech and language therapist. It is not widely known, including among medical personnel, that speech and language therapists can help with feeding. However, not all speech and language therapists will be experienced in helping with feeding difficulties but they will always be able to refer you to a therapist who specializes in children with cleft lip and palate.
If you are having difficulty being referred to a speech and language therapist you should contact the Cleft Lip and Palate Association of Ireland (e-mail: info@cleft.ie) where you will be put in touch with someone who can help.
If you have decided prior to the birth of your baby to breast feed, you should attempt to do so. Breast feeding is an option for both babies with a cleft lip only and babies with a cleft of the soft palate. The absence of the separation between the nose and the mouth which a palate gives makes it difficult for a baby with a palatal cleft to successfully breast feed. Success depends on your baby making a seal with his or her lips and being able to suck properly while not swallowing too much air in the process.
If breast feeding proves unsuccessful for you, you may wish to try bottle feeding with expressed milk.
This can be facilitated by the use of a breast pump which nursing staff can help you with initially. The time required to breast feed may also be a determining factor for you as breast feeding can be time consuming, more so for a baby with poor suction, as can the process of expressing milk.
Don’t be disappointed if breast feeding is not successful for you. It does not point to failure on your part and will not affect your bonding with your baby.
Bottle feeding can be made easier merely by using a normal teat with an enlarged hole. This will allow the milk to flow more freely. Special teats are available and may be recommended if your baby is having difficulty with a standard teat.
Positioning your baby differently may also help with feeding. You may find that using a more upright position prevents fluids coming down the nose. Whatever the position, it should be comfortable for both you and your baby. Referral to a dietitian is recommended for advice on dietary requirements.
Every baby is different, and you may have to try a number of different methods before you find one that suits you and your baby. Do seek the advice of a speech and language therapist if you experience difficulty, and the Cleft Lip and Palate Association can lend support and direct you further if you so desire.
