Feeding Protocol in Cleft Palate Patients

Feeding difficulty is usually the most serious and urgent concern after birth in children with cleft lip and palate. The cleft lip makes it difficult to make a seal around the nipple. The cleft palate results in an inability to generate negative pressure for sucking milk. Feeding assistance and education are needed soon after birth, by a feeding specialist or a nurse with expertise in feeding babies with clefts. Special feeding techniques and specialty feeding equipment are utilized. Breast milk is the best form of nutrition for an infant. While babies with an isolated cleft lip are able to breast feed via technique modifications, the vast majority of babies with cleft palate are unable to feed at the breast. Breast milk can be pumped by the mother and fed to the infant via bottle or cup. Various specialty feeding systems have been developed. Weight gain is used as a measure of adequate food intake. Infants should be regularly evaluated by a cleft feeding specialist to ensure optimum feeding until after cleft palate repair when normal feeding mechanism should be restored. Caregiver education is critical for success of any infant feeding strategy.