Hello, my name is Rachel Kresel. I am attending the University of North
Dakota and in my junior semester of nursing school. I joined this
listserv in hopes of becoming more educated in the breastfeeding area.
Throughout clinical and OB class it has been stressed that breastfeeding
should be encouraged if there are no contraindications for the mother or
infant. 
 Since being a part of Lactnet, I have read some posts concerning
babies born with cleft palates and breastfeeding. I thought that this
seemed like an interesting topic to research more in depth, as it can
make breastfeeding especially difficult. According to Johansson and
Ringsberg (2004) parents of infants born with cleft palate reported low
quality of advice on feeding. Infants with a cleft palate have a
difficult time with producing an effective oral suction when attaching
to the nipple.
 Sadler (2005) stated that the type of cleft palate the infant
has, rather than the way the baby is fed is more significant. Infants
with isolated clefts that involve both the soft and hard palate have
been found to have the most difficulties when feeding. The mothers
should still be encouraged to pump their milk with the use of a breast
pump or through manual extraction, if the infant is unable to attach to
the nipple effectively and be fed with a specialized bottle. Glass and
Wolf (1999) stress the importance of feeding the infant breast milk
through pumping or breast-feeding in protecting the infant from middle
ear infections, which are common problems for infants with cleft
lip/palates.
 Le Lache Legue International (1999) found that by placing the
thumb or forefinger to fill the space in the lip can help the baby form
a complete seal. Feeding the infant in an upright position is the best
position for infants to be in while feeding, as it helps prevent the
milk from leaking into the infant's nose which may cause it to choke.
 I was able to find some information that will be useful; however
I still have a few questions that maybe could be answered by someone who
has had experience in the area. I am wondering if anyone has experience
in the kinds of nipples that have worked the best for infants to latch
on to.  And are there any other ways of feeding the infant that seemed
to work well? 

Glass, R.B. & Wolf, L.S. (1999). Feeding management of infants with
cleft lip and palate and Micrognathia. Infants & Young Children: An
Interdisciplinary Journal of Special Care Practices, 12 (1), 70-82.

Johansson, B. & Ringsberg, K.C. (2004). Parents' experiences of having a
child with cleaft lip and palate. Journal of Advanced Nursing, 47 (2),
165-73.

La Leche League International (1999). Breast-feeding the baby with
special healthcare needs: Cleft lip or palate and cystic fibrosis.
Exceptional Parent, 29 (11), 52-54. 

Sadler, C. (2005). Palatable truth. Nursing Standard, 19 (43), 24-26.

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