Cleft Lip and Palate
Feeding Guidelines

Unilateral Cleft of the lip alone (no palate involvement)

• Use the breast to help seal the cleft/s

• Mother can place her finger over the cleft to occlude air entry and create a seal.

• Breastfeed with the cleft uppermost, use underarm hold and switch to the cradle hold on the other breast

• Breastfeeding outcomes for a unilateral cleft lip should be positive, the breast partly obscures the cleft and the mother can focus on the whole baby during feeds.

Narrow cleft of the hard palate

• Breastfeeding – if baby can take the nipple and some of the breast tissue into the mouth the breast may form a seal stopping air from entering from the nose and breastfeeding proceed naturally.

• Where breastfeeding is not achieved if there is a hard palate surface a normal teat from a bottle may be aimed to the side of the cleft eg if a right cleft aim the teat to the left.

Wide unilateral or wide bilateral cleft of the hard palate, with or without lip and soft palate involvement

• Initiate breastfeeding and observe if the breast tissue is able to seal the cleft.

• Where breastfeeding is not initially achieved use a Haberman feeder until the Lactation Consultant or Speech Therapist has visited.
  
  or
  

• The Soft Cup feeder may be the preferred first option if baby has a severe cleft, or baby is not achieving milk transfer with the Haberman.

• The Haberman feeder or Soft Cup feeder will be provided by the Clinical Charge Nurse in Newborn Services.

• Maintain lactation by expressing and provide expressed breast milk.

• Babies with large clefts may receive a partial palate plate at the Plastic Team follow up appointment which may lead to differing feeding options, and possible return to breastfeeding.

Clefts of the soft palate, unilateral, bilateral or bifud uvula

• Initiate breastfeeding, observe for slipping off the breast, need for frequent relatching, signs of milk transferring, clicking sounds may persist during feeds.

• Where breastfeeding is not initially achieved use a Traz Chuchu cleft palate teat with a Traz Chuchu squeeze bottle.

• Other options include a Traz Chuchu  Deluxe Super Cross Cut Teat – silicone, and Traz Chuchu Squeeze bottle.