Do you know what you need to live a healthy life? Nutrition! HEALTHY EATING is a key to a healthy life and food is one of the necessities of life, particularly in a child having a cleft lip and/or palate. As we know these children require feeding assistance due to several physical limitations, you need to be extra careful about their nutritional status.
In short, if you have to fulfill the nutritional needs of children with cleft deformities, you must bring certain feeding technique modifications to help them thrive, survive and grow.
Let us start with knowing some of the highlighted eating and drinking problems that baby with cleft lip and palate face. Depending on the scenarios, the feeding problems in newborns can vary and needs, as well. For instance, the babies with cleft lip can be breastfed but if the patient has a cleft lip and palate, or has only a cleft palate the breastfeeding does not stand a chance. To fulfill the needs, certain variations have to be done due to the opening in the mouth’s roof that makes the suction difficult. It means the life of the patients with cleft palate is tougher as they show poor weight gain, lack of energy, and imbalanced nutritional status. Besides, the baby will face nasal regurgitation, may inhale more air than food, and can show severe digestive issues.
Aim of feeding treatments
- To normalize the child’s eating pattern
- Evident and stable weight gain
- Comfortable eating and drinking without breathing issues or choking
- Easy suckling/sucking
- Help the baby avoid swallowing too much air
How will you know it’s working?
- Baby takes feed for approx. 30 minutes or more without feeling fatigue
- No choking
- Baby gains between a half an ounce to one ounce/day
Feeding with cleft deformities
Now the question is “how to feed the baby with a cleft deformity?”. Truly speaking, the answer is NOT simple and this act demands UNLIMITED EFFORT!
Feeding with cleft Lip
Babies having a cleft lip only, typically feed fine, particularly breastfed when faced upwards. Do you know why? Because the breast tissue tends to fill the upper lip gap.
Feeding with a Cleft palate
The newborns with only Cleft palate also get nutrition well because the newborns’ tongue wraps around the nipple just like non-cleft babies. The jaw also functions fine during suckling in certain cases. Though, most of the newborns having cleft palate fail to suck from the nipple and even bottles as air continuously leaks from the gap present between the mouth and nose.
It means breastfeeding or drinking from a bottle is not a good option. They require the use of special bottles or cleft palate feeder.
Breastfeeding an infant with a cleft lip
Breastfeeding is ONLY suitable for newborns having a cleft lip. Do not consider it an option for infants with cleft palate as it will only make the situation more critical. Do you know the reason why breastfeeding is not a sensible choice for cleft palate? Because they show poor suction.
If breastmilk is a necessity for a child with a cleft palate, due to its multiple benefits, you need to pump the breast milk and then feed the baby through a specialized bottle with tailored nipples. It must be chosen with the mutual decision of a feeding specialist, lactation consultant, and speech pathologist.
Advantages of providing breast milk
- Highly nutritious source
- Easier digestion
- Strengthens immunity
- Lower infection rate
- Lesser chances of allergic reactions
- Fortifies digestive system
- Protects from bowel issues
- Decreased chances of Sudden Infant Death Syndrome
- Encourages eye and brain growth
Feeding with special bottles
Regrettably, cleft palate infants cannot be breastfed and require feeding through special bottles made with specific nipples. Choosing the right feeding bottle for cleft palate can be a tough task. The best part is that you can get a variety of bottles designed to cater the needs of every infant.It is advised to practice bottle squeezing before start feeding.
Here are the safest, most feasible, and preferable bottle options you can choose from.
Dr. Brown’s Specialty Feeding System
Based on a one-way valve, it requires no special positioning for a bottle feeding. It stops the milk from flooding back into the bottle. The baby gets the milk by biting on the nipple rather than sucking. Nipple with various flow rates is available. The biting helps the baby self-pace the fluid flow rate.
Although it also has a one-way valve but its Y-cut nipple that is designed in two sizes makes it more suitable. The thicker side should rest on the upper gum, whereas the thinner side must be placed over the tongue. The nipple is either tightened or loosened to adjust the flow rate.
Medela SpecialNeeds Feeder (Haberman)
This one-way valve feeder only works when a caregiver squeezes the bottle. One thing you must take care of is to keep the baby’s sucking and swallowing pace matched up with your bottle squeezing.
Enfamil Mead Johnson Cleft Lip/Palate Nurser
It is similar to the Haberman in working and requires the effort of both, the caregiver and baby. Keep the sucking pattern and squeezing action in rhythm. You can use it with any standard nipple.
- Make your baby stay upright, or in a sitting position during breast feeding
- Try holding the baby in a semi-upright angle during bottle feeding to minimize the nasal regurgitation
- Prefer feeding in a calm quiet surrounding
- Tilt the bottle to keep the nipple filled with milk
- Make the baby burp more often
- Feed for a maximum of 20–30 minutes
- Never squeeze the bottle while a baby is swallowing or breathing
- Pick a compatible man-made palate prosthetic in case of cleft palate
- Follow the mixing directions to prepare the formula
- Initiate the sucking reflex by rubbing the nipple of the bottle on the lower lip
- Always squeeze gently
- A squeeze every 3-4 sucks are typically enough