Bottles for Infants with Cleft Palate

There are a few different bottle systems currently available for babies born with cleft palate (with or without cleft lip). Be sure to consult with members of your baby’s cleft team for more information and hands-on instruction.

Links:
– Medela SpecialNeeds Feeder: What is the Medela SpecialNeeds Feeder? | Medela

– Dr. Brown’s Specialty Feeding System – Dr. Brown’s Medical Specialty Feeding System (SFS) – Dr. Brown’s Medical

– Pigeon Cleft Lip/Palate Bottle – Baby Cleft Lip/Palate Bottle with 2 Nipples, 8.11 Oz – Pigeon

SpecialNeeds Feeder by Medela (previously known as the Haberman Feeder)

The Medela SpecialNeeds bottle is an assisted-delivery bottle with a long nipple. It is available in a small/mini size, for small or pre-term babies, and a standard size. There are five parts to the Haberman: a valve, a disk, a nipple, a collar, and a bottle. 

To use this feeder, fill the bottle with breast milk or formula. Press the thin valve onto the disk. Place the disk/valve into the nipple such that the side with the valve faces the inside of the nipple. Place the nipple structure onto the bottle and secure all the parts with the collar/ring. Hold the bottle upright, squeeze the nipple between your fingers, and tilt the bottle upside down. Release the squeeze. Liquid should fill the nipple. Repeat this process until the barrel is full. 

There are three rates of milk flow, each represented by a line on the barrel of the nipple: slow (represented by the shortest line), medium, and fast. The selected flow marker should be aligned with the baby’s nose. You should squeeze the nipple reservoir when the baby sucks and release it when the baby rests.  Flow rate depends on a combination of the selected flow, the infant’s compression and suction strength, and the feeder’s compression strength. 

To adjust the flow, rotate the nipple or change amount of pressure on the nipple so your baby sucks and swallows without gulping or becoming overwhelmed. In some cases, a baby will be able to draw milk from this nipple themselves, without requiring any assistance (compressions) from the caregiver, especially at the faster flow rates. At the slowest flow rate, compression from the feeder is needed. Finding the right pace and pressure can take some time and practice, so do not hesitate to ask your feeding specialist for support.

Dr. Brown’s Specialty Feeding System

The Dr. Brown’s bottle is infant-directed, meaning that the caregiver does not need to squeeze the bottle or nipple to aid the flow of liquid.

The Dr. Brown’s bottle comes with six parts: a disc-shaped valve, a nipple, a collar, a two-part vent system, and a bottle. To get started, insert the valve securely into the nipple. Push the nipple and valve into the collar so that it forms a good seal. Snap the vent system into place by putting the reservoir into the insert, then snap the vent system into the bottle.

Fill the bottle with liquid. Attach the nipple setup to the bottle. The nipple will fill with liquid as the baby begins to eat. Allow the baby to feed independently. 

The Dr. Brown’s nipples come in a variety of flow rates. It is usually best to start with a newborn nipple and increase to a larger size if your baby takes longer than 30 minutes to feed or seems to be straining or working too hard. Reduce the flow rate  if your baby seems overwhelmed with liquid or is choking or gagging.  Work with your team to find the right flow rate if it seems to slow or too fast.

Pigeon Cleft Palate Nurser

The Pigeon bottle is infant-directed, meaning that the caregiver does not need to squeeze the bottle or nipple to aid the flow of liquid.

To get started with the Pigeon, fill the bottle with liquid. Assemble the nipple, cap, and the collar, and attach the nipple structure to the bottle. Hold the bottle upright and squeeze the nipple between your fingers. Tilt the bottle upside down. Release the squeeze; milk should start to fill the nipple. Repeat this process until the nipple is full.

The Pigeon nipple has a hard side and a soft side. The hard side, which contains a notch-like air vent, should always be placed on top, under the baby’s nose. 

Allow the baby to feed independently. If the nipple collapses, the collar is probably too tight. Loosen the collar until the nipple decompresses, and then resume feeding.