ACPA Family Services

Tips for Hospital Nurseries

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Neonatal Cleft Lip and Palate: Tips for Nurseries

Ordering bottles for infants with cleft palate

Please refer to our Feeding Instruction Video for information on how to use these bottles.


Reassure parents that cleft lip and palate is correctable with surgery, and introduce the concept of a cleft palate/craniofacial team. A team is a group of specialized health care professionals (surgeons, dentists, speech pathologists, nurses, mental health specialists, and others) who work together to treat a child with a craniofacial condition like cleft lip/palate. If you don’t know of a team in your area, call ACPA Family Services at 1.800.24.CLEFT.

Reassure parents that the baby’s cleft is not their fault and was likely not caused by anything they did.

Review feeding instructions and refer to Feeding Your Baby Video, available online in English, Spanish, and Mandarin. To request a CD-ROM of these videos in English or Spanish, please call or email ACPA Family Services. Newborns with cleft lip only may be able to feed using standard techniques. Newborns with cleft palate benefit from the information following.

Assess feeding regularly to ensure that the child is receiving adequate nutrition.  Please consider the following guidelines for successful feeding:

  • Make sure the child is feeding in an upright position. Gravity will help prevent milk from coming through the baby’s nose if he/she has cleft palate.
  • Mothers interested in breastfeeding may choose to initiate pumping breast milk.  Direct breastfeeding is extremely challenging for a child with cleft palate since good suction is prevented by the cleft.
  • Use a cleft palate specialty nurser for feeding. Please see our Feeding Your Baby videos or booklet for specific instructions.
  • Caregivers should take their time feeding and burp the baby frequently. Infants with cleft palate tend to swallow a lot of air during feedings.
  • Eventually, feeding time should be no more than 30 minutes for 2-3 ounces.
  • If the child is still having difficulty feeding, consult a feeding specialist with a cleft palate/craniofacial team. The team’s nurse, speech-language pathologist, or social worker may provide this support.

Consult with a hospital social worker to provide the family with emotional support and community referrals.  ACPA Family Services is also available to provide support for urgent family needs at 1.800.24.CLEFT.

Contact the pediatrician or family doctor. Ask a physician where to refer for cleft palate/craniofacial team care, and make this referral before the child is discharged from the nursery.

Consult with a public health nurse if the child shows signs of feeding difficulty. Make sure that either the public health nurse or the team’s nurse will follow up with the family promptly.

Follow up with the family after discharge with a phone call to confirm that any new challenges are being addressed by the cleft palate/craniofacial team or other healthcare specialists.