Of the 100s of mothers of multiples I've worked with, several of whom had one or more with a congenital anomoly or condition, only one had a set of twins with one having a cleft lip and palate. This mother did exactly as Judy K suggests--while her daughter breastfed on one side, mom pumped (using electric pump) on the other side for her son. For six months the little boy received only breast milk. You may want to address the possibility of mom's potential differences in developing feelings of attachment with each baby. Although she may not experience a problem, many mothers find they attach easily/quickly to the "perfect" baby who is able to breastfeed. The "imperfect" baby is more easily passed to others for feedings and receives less maternal interaction. (It may help that babies with clefts can be difficult feeders--period--and mom is likely to be the one who learns best how to feed this baby too.) This mom will be extremely busy and may "put off" the grieving she needs to do about having a baby with an anomoly while simply trying to survive/physically manage two infants. Any time I bring this up, I find mothers are relieved because they were afraid that there was something wrong with them for having disparate feelings. (Occasionally mothers attach more readily to the 'underdog" with the problem, but usually it's the other way 'round.) Once aware of potential or actual problem with attachment, suggestions can be offered to increase/improve interactions facilitating attachment. (I went into this in a bit more detail in Keys to Parenting Twins; NYC: Barron's Publications). Feel free to give my phone number to any mother of multiples (if she is willing to pay the phone bill). Most of us with multiples desparately want to talk with another mother who's breastfed the same number of multiples--twins with twins, triplets with triplets, etc. E-mail me for that number. Karen G.