How Do I Feed a Baby with a Cleft Lip or Palate?

Feeding is often the first challenge parents face. Here is a guide to feeding a baby with a cleft.

Cleft Lip Schematic

Babies with cleft lip or palate have difficulty creating suction, making breastfeeding and bottle feeding challenging. With the right techniques and tools, most babies can feed well.

  • Challenges:
  • Babies with a cleft palate cannot create suction (air leaks through the cleft)
  • Milk may come out of the nose
  • Feeding takes longer
  • Babies may swallow more air
  • Weight gain can be slower

Feeding positions:

  • Upright position:
  • Hold the baby in a more upright position (45–60 degrees)
  • Gravity helps control milk flow
  • Reduces milk going into the nose
  • Allows the baby to pace feeding

Bottle feeding techniques:

  • Specialty bottles for cleft palate:
  • Dr. Brown's Specialty Feeding System β€” has a one-way valve and a specially designed nipple
  • Haberman Feeder β€” has a slit valve that releases milk only when the baby compresses it
  • Pigeon Bottle β€” very similar to the Haberman, widely used for cleft feeding
  • Nipple modifications:
  • A cross-cut or Y-cut nipple allows milk to flow without suction
  • The nipple should be long enough to reach past the cleft
  • Squeeze the bottle gently to start the flow if needed

Breastfeeding

  • Most babies with cleft palate cannot breastfeed exclusively
  • Some babies with a small cleft lip alone can breastfeed
  • Pumping and bottle feeding is a common approach
  • You can still provide breast milk by pumping

Tips

  • Feed smaller amounts more frequently
  • Burp frequently (more air is swallowed)
  • Keep the head elevated during and after feeding
  • Watch for signs of fullness
  • Monitor weight gain closely

Clinical Guidance

Feeding a baby with a cleft palate requires special bottles and techniques, but most babies feed well and gain weight with the right approach. Work with your cleft team's feeding specialist to find the best method for your baby.