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.