ACPA Family Services

Feeding FAQs

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The following FAQs are excerpted from the ACPA Family Services Feeding Video. To view a response in context of the video, please refer to the time listed in parenthesis at the end of each statement.

Can I find feeding information on the Internet?
Just because information is on the internet doesn’t mean it’s accurate or appropriate. In fact, sometimes it’s downright harmful and alarming. Go to as your first stop on the web, and then rely on your cleft palate team to recommend other reputable sources of information. (0:10)

Why does a baby with cleft palate have problems with feeding?
Because of the cleft, or opening between the mouth and nasal cavity, the baby can not create the suction which is needed to efficiently pull milk from the bottle or breast. It is like trying to drink from a straw with a crack in it. Your baby may take longer to feed or have milk come out of his nose. This is called “nasal regurgitation.” The baby may also swallow more air while feeding. Because of these problems, you need to make some changes, or adaptations, in the way you feed your baby. (0:38)

How much should my baby eat?
Your primary care provider will let you know how much breast milk or formula your baby should take. Usually a full term healthy newborn takes about 2-3 ounces of breast milk or formula per feeding — about 6-8 feedings per day. It’s important to understand that it’s normal for newborns to lose some weight in the first week or so of life, but by 2 weeks, your baby should be back to birth weight. It’s helpful to have your baby weighed once a week, on the same set of scales, for the first 1-2 months to make sure he’s gaining weight properly. (1:15)

How long should a feeding take?
Feedings should take no more than 30 minutes. If your baby takes longer than this, it may mean she is working too hard and may actually be burning up some of the calories needed to gain weight. Try to feed your baby every 3- 4 hours. If your baby feeds more frequently — say, every 2 hours — she may just be “snacking,” and may have problems gaining weight. Plus, you’ll feel like you’re feeding the baby all the time and both of you will be exhausted. (2:01)

How long can I let my baby sleep between feedings?
Infants in the first weeks of life should not sleep longer thn 3-4 hours between feedings. If the baby is receiving breast milk, more frequent feeds may be needed, because breast milk is more quickly digested than formula. Once adequate fluid volumes and weight gain are achieved, the schedule can be relaxed to an on-demand feeding schedule. (2:33)

How long do I stay with a feeding system that’s not working before I try something else?
When switching nipples or feeding systems, allow up to 48 hours for your baby to adjust. Switching systems too often may cause your baby to get confused and more frustrated. Be sure to consult your cleft palate team or feeding specialist during this process. (3:02)

I see milk coming out of my baby’s nose. I’m scared – what should I do?
This is very common in babies with cleft palate. Hold your baby in a more upright position. This will decrease the amount of milk coming though the nose. Your baby may even sneeze or cough, which also clears the nose. Then continue feeding. You don’t have to use a bulb syringe to suck milk out of the nose—the nose clears and cleans itself. Remember – nasal regurgitation is not dangerous and does not mean your baby is choking. (3:22)

Does my baby have acid reflux?
Reflux occurs when stomach contents back up into the esophagus. Reflux can cause vomiting, spitting up, coughing, or changes in sleeping habits. Reflux is different from nasal regurgitation, when formula comes out of the nose during feeding. Your primary care provider should be consulted about your baby’s reflux symptoms. A formula change or a thickening of the formula may be recommended, and in some cases, medication may be prescribed to manage this problem. (3:59)

What is a Cleft Palate Team and why should I have one?
Babies born with cleft lip or palate often require a variety of treatments as they grow. A cleft palate team is comprised of surgery, pediatric, nursing, feeding, speech, hearing, mental health and other specialties unique to your baby’s condition. By meeting with each other, and staying in communication as your child grows, these health care providers can individualize and coordinate the best treatment options. You can find a cleft palate team in your area by going to or calling 1-800-24-CLEFT. (4:39)