Feeding Management of Infants with Cleft Lip and Palate and Micrognathia

ABM Clinical Protocol #17: Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate, Revised 2013

“…Positioning should be semi-upright to reduce nasal regurgitation and reflux of breastmilk into the Eustachian tubes. 31,32,[34][35][36] (III) ii. A ''football hold''/twin position (the body of the infant positioned alongside the mother, rather than across the mother's lap, and with the infant's shoulders higher than his or her body) may be more effective than a cross-cradle position.…”

“…25,31 There was weak (III) evidence to suggest that partial breastfeeding (with supplementation) can be achieved and that the size and location of the cleft are determining factors for breastfeeding success. 35,36,45 As with infants with CL, modifications to positioning are reported to increase breastfeeding success. 30,31,[34][35][36] (III) 3.…”

“…35,36,45 As with infants with CL, modifications to positioning are reported to increase breastfeeding success. 30,31,[34][35][36] (III) 3. Can infants with CLP breastfeed successfully?…”

“…22,23 Modifications to positioning to increase breastfeeding success are recommended by experts. 29,30,32,35,36,38 (III) 4. Is there evidence to guide assessment and management of breastfeeding in infants with CL/P?…”

“…There are over 340 syndromes in which CL/P appears. 35 It is beyond the scope of this protocol to review and make recommendations for them all in detail. However, some key data are presented to guide breastfeeding practice.…”