A Tutorial for Feeding Infants With Orofacial Clefting: General Guidelines and Patient-Specific Intervention

Purpose: This tutorial outlines a suggested pathway to determine the appropriate feeding modality for infants with orofacial clefting depending on the affected facial structures. Current cleft-adapted bottles and flow rates are described. Guidance is provided regarding nipple flow rate selection and providing adequate daily volume. Other feeding strategies are discussed in the context of available research, such as nipple positioning, infant positioning, and milk fortification. Finally, components to consider in documentation are outlined and options for monitoring infants with orofacial clefting are discussed. Conclusions: The suggestions in this tutorial are intended to impart a framework for clinicians to use when providing feeding services to infants with orofacial clefting. As a result of this tutorial, clinicians should be able to complete an oral peripheral examination of the cleft, tailor feeding interventions to each individual infant, explain the purpose and mechanics of various cleft-adapted bottles, and recommend additional feeding strategies based on caregiver reported information and observation.