|Breast feeding and postoperative care of clef lip / palate|
Parents get to know that there is little difference in breast feeding between the cleft and the non-cleft baby though they are somewhat embarrassed at first. Cleft baby need same amount of the caloric uptake and nutritional support. Cleft baby has weak suckling power due to the cleft lip and/or palate, therefore the food tends to regurgitate over the nose. They are easily tired before the completion of the lactation because of this difficulty in sucking. In fact, it is very hard for the cleft baby to suckle via the nursing bottle. Therefore, cruciform hole on the nipple and squeezing a little during the breast feeding may be needed to help the cleft baby. It is recommended that breast feeding should not last more than 30 minutes. As they swallow air during the lactation, parents should make them belching intermittently. They have a tendency of sneezing and swallowing the wrong way, so they should be orthostatic in some degree during the milk feeding and with the slower rate than the non-cleft baby.
Following the palatoplasty, cleft baby should be in the prone position so that the intraoral bleeding should not be aspirated and discharged naturally. Immediately after the surgery, some bleeding is natural and parents don’t have to be worried about this. It is important for the cleft baby to leave the intraoral suture untouched. They should not put their hands into the mouth or suck their finger. If needed, restriction of the hands may be needed. Crying may cause the tension to the suture site and may result in the wound dehiscence so the parents should make them calm down and asleep. Although breast feeding is possible from the day after the surgery, syringe or spoon is recommended other than the nurse bottle nipple. After the milk feeding, water intake should be followed to remove the remainder of the milk on the suture site. Though stitches disappear in 2 to 3 weeks spontaneously, special care should be taken until this period and parents should not make them cry.