Basic problems connected with the care of children with cleft lip and palate
In case that the parents have problems with feeding the baby, they should as quickly as possible contact a specialist facility which treats facial cleft defects.
In Formmed the parents receive information concerning child care as well as a training of safe feeding of the child depending on the extent of the defect.
The primal activities of an infant are breathing and eating. Due to the fact that in children with cleft defects breathing and intake of food has a common tract, the mother should take care of the hygiene of the oral and nasal cavity. Gentle cleaning of the nasal cavity, done before the feeding begins, enables the child to breathe freely while eating.
The food intake in children with cleft defect is the more difficult the bigger the scope of the defect is. Surely the mother of the baby with cleft lip and palate will not be able to breast-feed. Due to the open connection between the nasal and oral cavity the infant is unable to feed despite the preserved sucking reflex. The cause of this is the inability to create a vacuum necessary to suck out the milk.
Currently there are various types of nipples and special bottles that make feeding of such babies much easier. The choice of the nipple depends on the scope of the defect – for children with large cleft palate a right nipple will be such that is wide and big, which would close the gap of the cleft during feeding; in unilateral clefts more comfortable may be a nipple which is long and narrow.
It is important that the milk flows out of the tilted bottle in big drops and that the baby is laid almost vertically, only slightly slantwise. The baby should be observed whether it swallows the milk and does not choke.
The bottle with milk should be held slantwise and as the amount of milk in the bottle decreases, it should be put vertically so that the child does not swallow the air. If during feeding the milk goes out through the nose the feeding should be paused, the nipple should be taken out of the mouth and you should wait for the child to swallow all the milk that is still present in the mouth.
In infants who do not suck efficiently it is advised to slowly dose the milk, pressing the nipple or the bottle (if it is soft enough) with fingers. In most difficult cases a feeding with syringe or a feeding tube can be implemented.
After feeding the child should be kept in a vertical position until it burps. Only then the baby can be put back into its bed.
APPLICATION OF DUMMIES AND SO CALLED PACIFIERS
Dummies of that type are not usually recommended both by the speech therapists and orthodontists, because they influence the dental occlusion disadvantageously and they contribute to the incorrect functioning of the tongue. Often though it turns out that the infant has such a big need of sucking (and most of the children with cleft defect are not breast-fed) then the dummy becomes the only soothing tool. In such situation a child can be given a dummy, but it has to be remembered that it cannot be present in mouth at all times.