Addressing Concerns for Parents

Immediate Concerns for Parents

If your newborn has a cleft lip and/or palate, you probably have concerns and questions. This section will help you cope with your baby’s most pressing needs.

Your primary care physician will care for your newborn immediately after birth. In the first two weeks you will also meet the members of the team – the clinical nurse specialist and the cleft surgeon – who are there to help with your child’s special needs.

Feeding Your Baby

A newborn infant with a cleft lip may be able to breast-feed or bottle-feed without any problems. But babies with both cleft lip and cleft palate or cleft palate alone will have trouble breast-feeding. Although these infants are able to suck and swallow, the cleft or opening between the mouth and nose, makes it difficult for them to create enough suction on the nipple to eat enough to grow.

It is very common for babies with cleft palate to have problems while feeding. They may take in air, feed very slowly, or bring milk or formula back up through their nose. You may be frightened when this happens, and you may worry that your baby is not getting enough formula at feeding time.

It is important to help your baby receive enough food to grow. In some cases, enlarging the hole in the bottle’s nipple maybe all that is needed. If not, special bottles and nipples are available to help your infant get the nutrition he or she needs and to make feeding easier. There are squeeze bottles that have a soft, cross-cut nipple such as the Mead-Johnson Cleft Lip and Palate Nurser. These special bottles help deliver milk directly into the baby’s mouth, making feeding less tiring. Squeezing the bottle in coordination with your baby’s sucking motion also allows more milk to flow into your baby’s mouth. Your doctor or the cleft and Craniofacial Program team coordinator can help you locate these bottles.

During feeding, it is helpful to hold your baby upright in your lap – Elevating the baby is important because this allows the formula to flow down to the stomach and keeps it from coming back up to the nose. Burp your baby as he or she pauses during the feeding

It is natural for you to be nervous at first. But you and your baby will become more comfortable as you gain experience. Your goal should be to keep each feeding time to 30 minutes or less so your baby does not tire and feeding becomes a pleasurable experience for you both. You should discuss any question related to feeding or formula with the clinical nurse specialist or your pediatrician.

There is also a video for mothers of newborns with clefts, produced by UC Davis Children’s Hospital, that deals specifically with feeding issues. To view, click here.

Nutrition

Since your baby may initially have feeding difficulties, you may be concerned that your child is not gaining enough weight. A 10% weight loss is normal for infants during the first two weeks of life. In the next few months, your baby should gain about three to seven ounces every week.

Your infant should be monitored on a weekly basis, either by your doctor or a team member, to ensure adequate weight gain. These weekly visits should be continued until a pattern of weight gain and growth has been demonstrated. Your primary care physician can provide guidelines for your child’s nutritional needs.