You'll find hundreds of files on cleft lip, cleft palate here on widesmiles.org.

This one is about: Breastfeeding the Cleft-Affected Newborn: Making it Safe


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Most mothers want the best for their children, and we all agree that breastfeeding our newborn children is best.  Breastfeeding ensures that baby is getting the best of all possible foods. Breastfeeding strengthens the mother-child bond. Breastfeeding is natural. And breastfeeding offers additional protective elements that help to ensure the health and well-being of our child.

When a child is born with a cleft, it is not a foregone conclusion that that child will not be able to breastfeed. If the cleft affects only the lip and alveolar ridge, there is a very good chance that the baby will eventually be able to breastfeed successfully. However, lacking an intact palate, most babies cannot form the negative pressure that is an essential ingredient to successfully latching on.

When a child is born with a birth defect - any birth defect - parents must initially grieve the loss of the perfect child they had imagined they would have. When that birth defect precludes breastfeeding, the mother suffers another loss - the loss of her imagined role as mother. And at the same time, she suffers the loss of control in her life.

Because some babies with clefts - even cleft palates - do indeed feed successfully at the breast, mothers who wish to try should be encouraged to do so. But there are some cautions that must be seriously heeded.

1) Be prepared for a great deal of frustration before there will be success. Contrary to popular thought, babies are not born knowing how to breastfeed. All babies must be taught how to use their instinctive rooting and suckling responses to elicit sustenance from a breast. A cleft-affected child has those same instincts, but she does not have the same structure that would help her to use those instincts for successful feeding. You and she must experiment until you find the method that will work for you.

2) Know the signs of dehydration and seek medical attention at the FIRST sign of problems. Because breastfeeding may be difficult for your baby, and because many attempts may result in either little milk or no milk at all getting into baby's tummy, you must be constantly aware of possible signs and symptoms of dehydration - a potentially LETHAL complication of breastfeeding frustration. The signs of dehydration include a sleepy, listless baby, a baby who wets fewer than 10 times per every 24 hours, urine that is strong smelling and/or dark in color and concentrated. If any of those signs are present in your baby while you are attempting to learn a breastfeeding pattern, take your child to a doctor or a hospital immediately.

3) Watch your baby's weight carefully. If your baby loses more than 10% of her body weight, or more than 1 pound, see your doctor immediately.

Go ahead and give it a try. If you and your child succeed in breast-feeding, the rewards can be immense. But don't be too stubborn about it. After all, your PRIMARY goal should be to put nutrition into your baby's stomach that will help her to grow and stay healthy.

Accepting that your child will not be able to suckle at your breast does not mean that she cannot be sustained by your breast milk. You may have to learn how to pump your own breasts and feed your child with a bottle.

Bottle-feeding your infant will not inhibit your mother-child bond. After all, your child's father may also be closely bonded to the baby, and he cannot breastfeed her either. Make sure there is a lot of holding and cuddling going on, and hold your baby close to your body when you do feed her.

Bear in mind that, while, all things being equal, breastfeeding is best, all things are not always equal and there are times when a bottle is needed to ensure the well-being of your precious child. Even though we know that the "breast is best", bottle feeding your infant does not constitute child abuse, and it could be the best way for YOUR child to eat.


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