Author: Redford-Badwal, D.A., Mabry, K., & Frassinelli, J.D.
Source: Dental Clinics of North America 2003 ;47: 305-317.
A cleft (or opening) can occur on the lip or on the palate inside the mouth. The incidence of cleft lip and/or palate varies with ethnic and racial backgrounds, geographic origin, and socioeconomic status. Infants with a cleft often need some modifications such as a special nipple or bottle to meet their nutritional needs in order to thrive and grow. This article discusses oral-motor and feeding issues related to the child with a cleft. Feeding options are presented as well as various bottles and techniques.
An infant with a cleft has similar nutrition requirements and the main priority in the first few months as for all infants is adequate nutrition. The major modification is in the how the infant will successfully drink. Feeding difficulties may include liquid coming out of the noise, poor suction, excessive air intake, frequent burping, and prolonged feeding times. It is important for the infant with a cleft to maintain good nutrition to increase resistance to infection, promote adequate weight gain to allow for surgical intervention and healing after surgery. Different methods have been used by craniofacial centers for successful oral feeding. Techniques include using an obturator (a device made to fit in the mouth to block the hole) or using a special bottle or nipple. Common nipples described are the Haberman Feeder, the Cleft palate nipple by the Pigeon company, and the Mead Johnson Nurser. These special bottle/nipples do not require suction for the baby to express liquid but have various adaptations allowing the caregiver to assist by squeezing the bottle or softer nipples that do not need suction just compression. There are also differing recommendations after surgery to close the cleft. Some doctors do not allow bottle-feeding for a period of time after surgery because the nipple will rub against the repair site. Breast feeding and dental disease are also discussed briefly.
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