A baby born with a cleft will need a bit of extra help to feed
Feeding difficulty can occur with any cleft type. The severity of the cleft doesn’t necessarily determine the degree of difficulty with feeding.
Cleft palate interrupts normal suction, as a seal cannot be created. If your baby has a cleft involving the palate, unfortunately s/he will almost certainly not be able to feed directly from the breast.
Unfortunately, parents of cleft affected babies are sometimes given incorrect advice.
Faye, Aidan’s mum says: After being given all the wrong advice in hospital (“of course cleft babies can breast feed” “Given the type of cleft he has – soft palate cleft – he can use a normal bottle”) we came home and would spend two hours at a time trying to get him to feed. We did this for two weeks before contacting CleftPALS for help. After talking to CleftPALS we got a Queensland bottle and a Pigeon teat and went from two hours for a feed to half an hour the first time we used it. In the end, we could get through a feed in 15 minutes.
Cleft lip (intact palate)
Babies born with a cleft lip only can occasionally breastfeed. The baby needs to be positioned so that the cleft is filled with breast so that a seal is created. The advice of a breastfeeding counsellor experienced with cleft babies, or a parent of an older cleft baby who was able to breastfeed, may help.
Susannah, Leo’s mum says: We were happy to find Leo could breastfeed. It took quite a lot of work and a full day of help from a breastfeeding counsellor to get things going and I had to lean over to one side and wiggle about and it wasn’t at all a traditional breastfeeding position but it worked. We tried him on a bottle too and he couldn’t get on with a normal bottle at all, he just didn’t have the strength in his lip, so then we tried the Queensland bottle and chu-chu teat and that worked fine. I thought after his surgery he’d be able to use a normal bottle but it never worked for him, so we carried on breastfeeding and bottle feeding from the Queensland bottle until he graduated to cups.
Many cleft lip only babies or babies with microform clefts are not able to breastfeed or to use a “normal” bottle. Some can breastfeed but can’t use a normal bottle. Others can’t breastfeed but can use a normal bottle. For any cleft affected baby, it’s a good idea to have a special bottle such as Special Needs Feeder (Haberman’s) or Queensland / squeezy bottle on hand.
How your baby feeds is no reflection on the type of parent you are. Sometimes the professional advice can be contradictory or just plain wrong. Don’t blame yourself. The most important thing you can do for your baby is persevere with love and patience and work out the way that works best for them.
Most common feeding solutions for newborns
Most cleft babies are fed using a special bottle:
- Formula feeding through a bottle
- Expressing breastmilk and feeding through a bottle
Cleft babies usually require special bottles and teats such as the Special Needs Feeder (Haberman). CleftPALS has information on bottles. Call our Feeding Equipment hotline on 0425 784 130.
For help on long term expressing, the Contact Parent hotline can team you up with a mother of a cleft affected baby who achieved this; or try the Australian Breastfeeding Association.
How to use special bottles
For help with bottles, call the Feeding Equipment Hotline.
This video shows Mandy Haberman talking about the Special Needs Feeder and showing how to put it together.
This video shows how to use a Pigeon teat with a squeezy bottle (such as the Queensland bottle)
Feeding solids to a cleft palate affected baby
Parents of cleft palate affected babies often ask if they need to do anything different when starting their little one on solids. Experience varies:
Faye says: I didn’t do anything different in introducing solids to my cleft child than I had with my non-cleft child. Because he had to have “soft” diet after surgery for around four weeks I did find he was slower taking lumpier and finger foods.
Sherree says: I have had a few dramas with feeding solids.. At 14 months we are still on mashed foods and very soft things in small portions. He seems to gag on anything chunkier. I am waiting to see someone later this month about the situation. And I find him slower at taking lumpier and finger foods.
Tammy says: Courtney was very slow at handling lumpier foods and still prefers mashed potato over anything else. She struggles a lot eating meat and will spit it out rather than finish trying to chew it and swallow. My only trick is to try and hide things in her potato mash, cauliflower and cheese works best being a similar colour. She does like Bolognaise also as I have the meat very fine and I add mash vegetables such as peas, broccoli, spinach in. I used to also add pureed apple in to sweeten it up when she was younger, but don’t have to any more. It has been a challenge and eating any sort of fruit never happens. The only one she will contemplate is banana, because it is soft, but she won’t eat apples or pears. My speech therapist and she has given me some chewing exercises to help her strengthen the muscles involved for eating and can be done from a young age.
Stacey says: I didn’t do anything different. Being the third child, he just had to fit in and pretty much ate whatever we were eating. He was very unimpressed at having a soft diet for 6 weeks after surgery, but after that was straight back to normal.
We recommend trying standard “starting your child on solids” advice and seeing how you get on. Work with your sympathetic MCH nurse. If you need help, contact your GP, pediatrician, cleft clinic or a specialist speech pathologist, or call the CleftPALS Contact Parent helpline.
We are volunteers, not medical professionals. Information on this site is not a substitute for professional advice and no responsibility is accepted by CleftPALS.