(i) Feeding problems that children are prone to
1.It is not easy to suck milk, feeding is easy to fatigue.
2.Easy to choke and cough, inhale too much air and flatulence.
3.Insufficient intake leads to unsatisfactory weight gain.
(II) Breast milk or bottle
The benefits of breastfeeding: breast milk is safe, economical, and Breast milk contains all the nutrients needed by infants, can improve the immunity of infants, can enhance the relationship between mother and child, increase the infant’s sense of security, and help infants develop physically and mentally, so breastfeeding is promoted.
For children with unilateral cleft lip and some children with cleft palate, breastfeeding can be carried out. Breastfeeding is easy to achieve negative intraoral pressure and breastfeeding because the breast can be flushed to fill the cleft.
For children with severe deformities that cannot be directly breastfed: breast milk can be sucked out and bottle-fed.
(iii) Breastfeeding method
It is generally used to bring the cleft side close to the breast so that the soft tissues of the breast can better fill the cleft to assist in reaching the closure of the lip, which can exercise the sucking function.
(iv) Bottle-feeding methods
1, you can make palatal guards to assist in feeding, which can greatly improve the efficiency of feeding.
2, the choice of teat and bottle: it is recommended to use a soft teat, which can reduce local frictional stimulation, and it is recommended to use a horizontal opening or cross opening teat with a bottle that can be squeezed to facilitate control of the flow rate during feeding. If the bottle can be squeezed, parents need to practice squeezing the force to control the flow rate of feeding when the size of the nipple aperture is certain.
3.Feeding position: Hold the baby obliquely at an angle of 35~40 degrees from the ground to help the milk flow into the mouth by gravity and avoid entering the eustachian tube and middle ear secondary otitis media.
4.Pacifier position: Adjust the pacifier so that it is located on the inside of the non-cleft side of the cheek instead of at the throat, and gently press the bottle to match the baby’s action of sucking on the pacifier so that the milk can easily reach the root of the tongue and the swallowing reflex can occur naturally to achieve uniform and effective feeding
5. Flow rate: Feed the baby several times with a smaller flow rate first, and after the baby gets used to it, the flow rate can be enlarged for feeding. If choking occurs that may be caused by too fast a flow rate, it is recommended to switch to a pacifier with a smaller opening.
(v) Spoon feeding
If it is difficult to use a bottle, spoon feeding can also be used. When using spoon feeding, a small amount of food should be fed several times and slowly by holding the child in your lap or sitting in a baby chair, taking a small amount of food with a spoon and placing it on the child’s lips, encouraging the child to move the food in the spoon with his lips. The feeding speed depends on the child’s condition, and the feeder decides when to feed the next bite according to the child’s needs.
(vi) Feeding precautions
1. Avoid taking in too much air, feed in small amounts several times, and burp after meals.
2, reduce local stimulation, should avoid radical food to reduce local discomfort.
3, milk will backflow out of the nose, this is a normal phenomenon, there is no need to be too alarmed, just stop feeding temporarily, wait for the child to cough or sneeze and then continue feeding.