I was wondering if anyone out there has had success with creating a policy within their hospital when it comes exclusive breast milk feeding of babies born with a cleft palate. Our issue is not so much the cleft lip, of course, which is easier to deal with. But when there is a cleft palate, we are being told that they want the baby bottle-fed by 12 hours old and if there is not enough colostrum to go into the specialty bottle, then we need to supplement with formula (so they can get used to the bottle). The MD's are concerned that the parents need to practice using it before discharge. Also, I'm being told that the baby needs to gain weight before they can have surgery. However, the first surgery is not typically until they are 2 months old. I'm just wondering if anyone else has encountered this? How do you feed colostrum to a cleft palate baby? We typically have trouble putting 1 ml of colostrum into a bottle and don't usually see increased volumes for 48 to 72 hours even though we get started pumping and hand expressing right away.

We have had success by taking a 1 ml syringe, sitting baby upright, getting them suckling on a gloved finger, and then inserting it in the side of the finger. Or we have also spoon fed them sitting upright. Any other suggestions would be helpful.

I think we need to organize and talk to the Cleft Palate Foundation as well about some of their booklet they have created for parents. There "Getting Started" page lists only formula feeding and makes no mention of breast milk at all. And they are very negative about breastfeeding and essentially say, don't even bother. Just bottle-feed breast milk. It was very disappointing to read.

Thank you,

Tricia Shamblin, RN, IBCLC

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