Cincinnati Children's Hospital Medical Center Logo

Babies / Infants Feeding

Cleft Lip / Cleft Palate Bottle Feeding

General and Community Pediatrics

Because of your infant's condition, some different types of feeding techniques may be needed for you and your baby to have a successful feeding time.

The problem is simply a lack of normal suction because of the abnormal opening from the mouth to the lip and / or into the nose.

The goal is to provide your baby with enough calories to achieve a weight gain, but it is just as important to establish the parent / infant bond relationship.

Normally a full term infant will have a weight loss immediately after birth but by the tenth day of life the baby will regain his / her birthweight. For any infant, poor weight gain can be a sign of a feeding problem. For this reason, your baby's weight will need to be watched closely.

Feeding time should be 20-30 minutes to take 3-4 ounces of milk. At first, this time may be longer, but once the feeding technique is established, the time should decrease to 20-30 minutes. If longer, your infant will tire and use up more calories than he / she takes in.

Emotional Care

 

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.

Supplies

The doctor will help choose the device that best meets your baby's needs. Items in the list below may be suggested by your child's doctor.

 

  • Nipple
      • - NUK® Orthodontic nipple
      - Premature infant bottle nipple
      - Mead Johnson Cleft Palate Feeder nipple
      - Playtex® nipple
  • Bottle
      • - 8 oz. size
      - Flexible, not rigid or glass
      - Mead Johnson Cleft Palate Feeder
      - Playtex® Nurser with plunger (Note: a rolled diaper may be used in the bottom of a plastic bottle to plunge the formula)

Procedure

 

Holding your infant

            Holding your child plays an important role in successfully feeding and bonding with your infant. Hold your baby with his / her head elevated in a 60-80° angle in your arm. Your baby will be in a sitting position. This will help him / her swallow and prevent the milk from flowing into the nose.
            Arrange it so your infant can look at your face during the feeding. This way you can observe any problems that may occur as well as nurture and communicate with your infant.

            Alternately, until your infant gains better neck control, you may sit your infant upright on your lap with his / her side cradled against you. Support your infant's head with the heel of your hand against his / her back. Hold your thumb behind the angle of your infant's jaw on one side, and place your middle finger behind the angle of his / her jaw on the other side.

          Preparing the nipple

            Before using the nipple, it will need to be crosscut to enlarge the hole.  

            1. Turn the nipple inside out.
            2. Cut a small "X" over the hole with a manicure scissors or razor blade.
            3. Turn the nipple back so it is right side out.
            4. Sterilize the nipple prior to use.

          Feeding your infant

             

            1. Place a cloth diaper or washcloth under your child's chin to catch excess milk during feeding.
            2. Stimulate the suck reflex by gently rubbing the nipple against your child's lower lip. Insert and then invert the bottle.
            3. Gently squeeze the bottle in pulses to assist milk to flow into mouth. Squeeze once every 2 or 3 sucks. Infants rest every 15-20 seconds to breathe; do not squeeze when your baby stops sucking.
            4. If your 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. If your infant gags frequently, the nipple opening may be too large and a smaller size may be needed.
            5. Burp your baby often, about every ounce, since he/she may swallow large amounts of air during feeding.
            6. After each feeding, give your baby 1/2 ounce of water to rinse his / her mouth. Gently clean nostrils with cotton swabs.
            7. If your baby has wet burps, place him / her on his/her side in an angled infant seat, or place your baby in a crib and raise the head of the crib 6 inches.

          Special Instructions

           

          • 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, to look up at their caregiver, to 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.
          • Call your child's doctor if feedings are usually taking 45 minutes or more.


          Rev. 6/08