Feeding the new baby
 Fluid moves during infant feeding because of changes in pressure. The lips form a seal around the nipple/teat. The nipple/teat is held between the tongue and the hard palate. The tongue compresses the nipple/teat against the hard palate and “pushes” the milk out. The soft palate lifts to close the nose to create a vacuum, and suction “draws” milk out of the nipple/teat. The combination of compression (pressure) and suction (vacuum) make up the action of sucking. However, babies born with a cleft of the lip and/or palate often have difficulties with sucking from the breast or bottle. It is common for feeding to take extra time. Babies can often work too hard and become exhausted. Careful assessment and monitoring can prevent this and a suitable feeding method and pattern established. There are a number of methods available for feeding babies born with a cleft. Parents should be encouraged to try to find the best method for their own baby. Babies with a cleft lip only These babies can often breastfeed successfully. Placing the baby in an upright position with the cleft covered by the mother’s finger or breast tissue can aid attachment and reduce air intake. The secret is to create a seal where no air passes through. When the cleft is more than 1cm wide or is bilateral then poor lip seal can make breastfeeding more difficult. Babies with a cleft of the palate only Occasionally, babies with a cleft of the soft and/or hard palate can breastfeed if the cleft is quite narrow. They are usually unable to “draw” out of the teat/nipple and therefore are unable to suck properly. They take a long time to feed and get tired. As there is no closure of the soft palate, the infant can often take in large amounts of air and will need repeated ‘winding’. Assisted feeding with a soft “squeeze” bottle is very successful. As the baby sucks, the carer squeezes the bottle and delivers the milk into the mouth for the baby to swallow. Cup or spoon-feeding is also effective, but more spillage may occur, so always give a little extra amount of milk! Babies with a cleft lip and palate | My son was born with a unilateral cleft lip and took to the breast very well from birth which was a huge surprise but after his operation he just did not want to go near the breast. Anthea, Cape Town Haberman feeders
(special needs bottles) are quite expensive – we use a soft plastic bottle (called Pigeon feeding
bottle with spoon) or a plastic (not hard plastic) Baby Club bottle with a
regular silicone teat (winged or cherry shaped) with a medium round hole
allowing for a faster flow – then as the baby sucks, the feeder just squeezes
the bottle instead of the teat as in the Haberman. Of course, using a syringe
or a cup (bottle cover) is fine as well – just a little messy. As long as milk
is placed in the mouth, baby will swallow fine - as long as the cleft is
an isolated problem!
Parents must understand that the baby sucks, but cannot push or pull milk out of teat or nipple, since the oral cavity is not a sealed chamber- positive and negative pressure cannot be generated which is essential for efficient sucking. For more
information you can call Roslyn on |