Cleft Lip / Cleft Palate Bottle Feeding

Infants with cleft lip and/or cleft palate usually benefit from modified feeding techniques to make feeding enjoyable and successful. 

The goals when feeding any baby are to:

  • Provide adequate nutrition for growth
  • Choose a safe and supportive feeding method and supplies  
  • Establish and maintain a nurturing parent / infant bond relationship

Infants with cleft lip and/or palate need modifications to overcome the decreased or lack of oral suction that is caused by the air movement through the opening in the upper lip, nose or roof of the mouth (cleft). 

Normally a full-term infant will lose weight right after birth but by the10th day of life the baby will return to or be above his / her birth weight. For any infant, poor weight gain can be a sign of a feeding issue. Despite having a cleft, these infants are able to meet the same feeding and growth goals with the right interventions. For this reason, your baby's weight will need to be watched closely.  

The most common concerns for parents when feeding an infant with a cleft is lengthy feeding times and eating a small amount. Feeding time for all infants to get the necessary volume should be 20-30 minutes. Infants with clefts should not be fed for longer than 30 minutes, as the infant will tire and use up more calories than he/she takes in. A member of the healthcare team who is a cleft feeding expert will teach parents how to feed their baby.

Feeding time is a shared time between your infant and you. In order for you to hold and feed your baby in a relaxed manner, you need to feel at ease with the feeding style needed for your infant.

Remember, as with any infant, you may need to make changes to find the right style for your infant and you.

The healthcare team will help choose the modified feeding supplies to best meet your baby's needs. The Mead Johnson Cleft Palate Feeder, the Medela Special Needs Feeder (formerly known as a Habermann Bottle) and the Pigeon Bottle / Nipple are the most commonly used modified feeding supplies in the United States. Further modifications, selecting another nipple or using modified nipples, are sometimes used with the Mead Johnson Bottle. However, this should only be considered after consulting with a cleft feeding expert.  

Holding Your Infant

Holding your child plays an important role in successfully feeding and bonding with your infant. Hold your baby in an upright sitting position. This will help your baby swallow properly.

Arrange your baby so you can see his/her face during the feeding. This lets you see how well your baby is tolerating the feeding modifications and allows you to nurture and communicate with your infant.  

Feeding Your Infant 

  • “Pulse squeezing” the bottle or nipple is a common feeding technique used in combination with the Mead Johnson and the Medela Special Needs Feeder. To do this, gently squeeze the bottle (MJ) or the nipple (Medela) to help milk to flow into the mouth. A brief squeeze once every 2 or 3 sucks allows for a limited amount of milk to flow into your infant’s mouth. Only use these intermittent squeezes when your infant is actively feeding (moving lips against the nipple). Infants rest every 15-20 seconds to breathe; do not squeeze when your baby stops actively feeding.
  • Properly fill the Medela and Pigeon nipple with milk and place in your baby’s mouth with the correct side up. If the lines or notching on the bottle have not been explained to you, ask an expert.  You will need to know how to correctly fill and place the nipple.
  • If the infant gags or starts to choke, stop feeding and allow him / her to finish swallowing the milk already in the back of his / her throat.  
  • Burp the baby often, about every ounce.  Infants with cleft can swallow more air during feeding. Proper feeding techniques help limit this complication. 
  • Your baby may have a pacifier.
  • It is important to know that with any infant, there is more to the feeding time than just eating. Studies have shown for every 10-15 sucks, infants will stop their feeding for up to 3-5 seconds to rest, breathe, look up at the caregiver, smile, etc. Take this time to enjoy your special contact with your baby.
  • If your baby is not gaining weight, or if problems with the feeding persist, call your child's doctor. Other devices and methods may be needed to help your infant.
  • If your baby is not gaining weight, or if problems with the feeding persist, call your child's doctor and your craniofacial center providers. Your baby may need other devices and methods to help with feeding.

Last Updated 08/2014