FeedingCleft Lip & Palate

Those are some commonly used bottles:

• Specialneedsfeeder(Haberman):It includes a one way valve that allows easy flow of liquids and prevents back flow, this feature will reduce the amount of air swallowed. It provides a standard (high, medium and low) flow and it allows the feeder to control the flow. • Mead-Johnsoncleftpalate

nurser:It is a soft squeezable bottle with a standard crosscut nipple. The collar size is standard allowing easy use of other nipples such as the Nuk nipple or Ross nipple. However maintaining a consistent flow with the Mead-Johnson cleft palate nurser can be difficult.

• Pigeonfeeder:It is firm on top and soft at bottom, the soft side is placed against the tongue for easy compression. It includes an air valve that prevents the nipple from collapsing. The rate of flow can be adjusted by tightening or loosening the cap. It also has a standard nipple size that makes it easy to fit on any standard bottle.The rate of flow can be adjusted by tightening or loosening the cap.This feeder is more suitable for children with unilateral or soft palate clefts.Disadvantages of this feeder are the fast flow and the large size of the nipple, which may be too large for the infant’s mouth.

SLP 16-021 1437/20161437/2016

Prepared by: Speech Language Pathology

King Faisal Specialist Hospital & Research CentreCorporate Social Responsibility

P.O. BOX 3354 Riyadh 11211Kingdom of Saudi Arabia

Tel : +966 11 4647272

Website: www.kfshrc.edu.sa

CLP, also known as Orofacial Cleft, is a congenital opening in a structure that is normally closed. It could occur in the lip, palate or both. A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. It happens due to an abnormal fusion of the lip and palate during the development of a fetus. In many cases, CLP can result in feeding problems. Here, you will find some information regarding feeding methods that can be utilized with CLP infants or children.

Breast-feeding:Whether or not breast-feeding will be possible depends on the location and severity of the cleft. If a child has a cleft lip with no other medical condition, the child will be able to feed normally. When the alveolus is involved, assistance with breast-feeding is recommended.

FeedingCleft Lip & Palate

Prior to breast feeding initiation, it is highly recommended to prepare the infant and stimulate his oral feeding by providing minimal amounts of liquids using one of the ways below: • Finger feeding • Cup feeding • Syringe • Soft feeder

2. Self-expression into the infant’s mouth: The infant must be seated in an upright position on the mother’s lap, the infant’s mouth must be brought as close as possible to mother’s nipple then the mother starts expressing milk in a rhythmic motion while avoiding directing the milk to the cleft site.

There are two ways of providing sufficient breast-feeding nutrition:

1. Supplemental Nursing System (SNS): consists of a container and a capillary tube leading from the container to the mother,s nipple. The SNS container can be filled with fresh pumped breastmilk or infant formula. The tubing is usually attached with removable tape and the milk flow can be controlled. When the infant suckles on the breast, the infant is nourished both by fluid from the capillary tube and by the mother’s breastmilk from the nipple. In CLP infants, the tube must be directed away from the cleft to minimize milk backflow into the nasal cavity.

Bottle-feeding:• For children with isolated cleft lip:

Regular bottle can be used while monitoring the flow.

• For children with cleft lip with alveolus: Easy flow nipple is recommended.

• For children with cleft palate with or without cleft lip: Poor sucking skills will result thus, special bottles are recommended.

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