Breastfeeding 

A baby with a cleft lip can usually breastfeed. Sometimes there is difficulty in forming a seal between the breast and lip , but depending on the type of cleft, the breast can mould to the defect. A hissing sound usually means air is entering the mouth so reposition baby on the breast.  
You may need to experiment with your baby in different positions and seek support from those experienced with feeding children with clefts. This could be a feeding advisor in your cleft team or a parent in a local CLAPA group. A good flow of milk helps and this can be encouraged by massaging the breast or using a breast pump. Your midwife will be able to help with this aspect. Do remember that some babies without a cleft may also have difficulties breastfeeding successfully.  

There are some booklets written specifically for mothers who wish to breastfeed their baby with a cleft. ( see Other Help ) 
 

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Again the seal is required at the lips in order for a baby to feed efficiently. Some babies feed well with an ordinary bottle and a soft teat, although the hole may need to be enlarged or a new one made. This can be done by using a sterilised needle or paperclip. Heat the tip of the needle or paperclip in a flame until it's red hot. Make sure the needle is in the flame for at least one minute so that the natural carbon formed on the metal during heating is burned off. If it is not burned off, the needle will leave a black mark on the teat that is hard to remove.  

A soft bottle which can be squeezed as the baby sucks, may help if the baby is working hard but not able to complete a feed in a reasonable time, say 30 -40 minutes.  

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Babies with a cleft lip may take in more air than usual because of an incomplete seal on the nipple or teat. If your baby appears to be windy try the methods suggested in the introduction.  
 

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Feeding may recommence by breast or bottle. However some surgeons prefer you to feed your baby using a cup and spoon type method for a while. Also some teams feel that sucking on a dummy may damage the repair. Do ask for the advice of your cleft team or the ward sister so that your baby can get used to any changes before the operation.  

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