A cleft lip is usually repaired at 3 to 4 months of age. Surgery routinely involves a 2-5 day stay in hospital and establishment of feeding before going home. You will then return approximately 1 week later for another day surgery to remove stitches unless dissolving type are used.

Guidelines for surgery vary depending on the surgeon and the baby’s individual features. The surgeon will have the last word on the feeding regime for your baby as the repair can vary as much as a cleft varies from one child to the next. You will need to discuss feeding with your surgeon and your hospital at your appointment before surgery is scheduled.

For cleft lip only babies who have been established with breastfeeding prior to surgery, in most cases, breastfeeding will be able to continue soon after. For a short time, this may not be possible. It is a good idea to be prepared with the feeding equipment for bottle feeding if breastfeeding is not immediately possible.

Your child will not be able to feed from a teat in the days after lip repair. Doing so could damage the newly joined tissue causing tearing, scarring and damage to the lip. CleftPALS Qld have liaised closely with QLD health professionals and recommend the following two post-operative feeding options:

Follow the guidance of the treating health team including dieticians, speech pathologist, nursing staff and your child’s surgeon should assist. If you have concerns or difficulty or just need to talk about surgery and feeding, please feel free to phone CleftPALS Qld.
Please note that Qld Health do not recommend food value products being added to milk bottles.

The Pipette or “Witches Hat” fits into the squeeze bottle and is used by inserting it into the corner of baby’s mouth and squeezing the milk either down the side of the mouth, across the tongue or across the gum area. The baby will “lap” the milk with his or her tongue. This is the most commonly used option for lip surgery during the post op feeding period, and the pipette can be used with water too.

The Douglas Bean Scoop also fits directly onto the bottle, replacing the teat. It has a spoon-like scoop and the milk flows through a hole at the base onto the spoon area. The baby is fed the milk with the spoon resting on the bottom lip or gum, feeding front-on rather than from the side of the scoop.

Syringe Feeding is NOT RECOMMENDED due to the risk of accidentally bumping the baby’s face and difficulty with adequate sterilising of syringes.
Using the attachments with the bottle gives you more control over the flow of the feed and allows you to reuse the equipment safely.

The post op feeding regime is usually continued for 2 – 6 weeks after surgery. Each surgeon has different guidelines, therefore please check with your surgeon and follow their instructions accordingly.

For cleft lip only babies, it is not advisable to hold or burp baby over the shoulder. Sitting baby on your lap, and gently rubbing their back is best for burping.

Nasal Stents
Children with cleft lip are often required to wear nasal stents after surgery. The small silicon pair of tubes is around half to three quarters the size of a 5c piece. They are placed into the nostril to help shape the nose as it heals, and are secured with paper or fabric tape.

Stents can become clogged and block the nostrils. This has a huge impact on feeding. If your baby is refusing to feed, consider removing and cleaning the nasal stents while feeding and replacing them straight after feeding. In cases where the surgeon has opted to use stents, these may be required to be worn for up to three months after lip repair. The length of time these are required to be used depends on the surgeon’s instructions.

Health professionals do not typically recommend the use of dummies for cleft affected children. They are often unable to form the seal to correctly hold the dummy correctly and as a result can find it both tiring and frustrating. In addition to this dummies are not to be used during the post operative period.