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This one is about: Starting Your Cleft Affected Baby on Solid Foods
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A parent writes:
We have a daughter who was born with a unilateral cleft lip and hard palate and bilateral soft palate. Her lip was repaired at 3 months and she's doing just great. Her palate will be repaired in a few months.
QUESTION: We are just starting her on solid foods. We have a lot of trouble with formula coming out her nose, so I am worried about adding food to her diet. What have people done when starting their kids on food?
You will be introducing solids soon. It is a wonderful milestone for your baby and should not be approached with trepidation. For a child with a cleft, it will be only slightly different than with a child that has no cleft. The difference is that the cleft-affected child must learn a skill none of the non-cleft affected babies have to learn - to use the tongue to control the direction of the food (keep the food out of the cleft). They'll learn it. Give it time.
The trick to it is to start out with solid foods that are diluted. Make them very liquid at first and then slowly decrease the dilution until she is eating the baby food just like all the other babies at this stage of development. It should take maybe a week to get there.
Just try a little tiny bit at a time. She needs a little time to learn how to use her tongue to control the direction of the food, so diluting it first will allow gravity to help her out.
In response on when to start solids... (This is Laura, the Lactation Educator) A baby shows interest in eating solids by watching you eat and mimicking your motions by opening his/her mouth, like you. It is important to start a child on solids at around six months, so they can learn to move the food to the back of their mouth, and not forward or up the cleft - both of which they will do at first. It takes about three weeks to master this motion. Start with baby cereal mixed with breast milk or formula, rather runny. Keep bibs, wash cloths and a bulb syringe very handy, as the baby's tend to sneeze up the food. If you wait too long, say a year, to start solids, some children will gag a lot, and refuse to eat. It's not important for the nutrition aspect, but more for physical development. Does that make sense? Follow your baby's cues, and check with your pediatrician.
Laura Fess, C.L.E.