Case : Feeding Baby with Cleft Lip and/or Cleft Palate

Written by dr. Shella Riana


Baby V, male, with bilateral labiognatopalatoskizis (or known as cleft lip), was born spontaneously in the midwife on July 23, 2017. The infant was the first and only child at 38 weeks’ gestation. The baby was born with a weight of 3300 gr, 48 cm body length, head circumference 31 cm, and chest circumference 35 cm. When she was pregnant, Mother, namely Mrs.W, routinely took examination in the midwife. Mrs. W once performed a one-time ultrasound in hospital with obstetrician at 24 weeks’ gestation.
At the age of less than 24 hours, the baby was referred by the midwife because of the condition of his cleft lip. Infants and consent to lactation physicians for lactation management in infants.
After discussions with family, doctors, and lactation team, baby would use “special nutritional feeder” or “Haberman feeder”. This Haberman Feeder will be filled with Mother’s breastmilk. During the first day of observation, the introduction of haberman feeder was done by lactation physician and nurse to the baby. The baby was drinking well, he didn’t choke and there was not any aspiration and the formula ingested by baby was 15 cc (at that time breastmilk is not available yet). Next, Mrs. W had to pump her breast every 3-4 hours. In one day, lactation counselors had to visit Mrs. W twice.

The second day, parents got consulted by lactation consultant. The points presented in the counseling were about the benefits of breast milk and the dangers of the formula based on Al-Quran and WABA (World Alliance of Breastfeeding Action), about the stage of treatment, and asked parents to do the administration to BPJS. Then, the counselor taught them how to get nutrition with Haberman feeder to baby and his Father. The baby’s father looks smart and the baby was drinking well continuously, and he drank 35 cc of breastmilk.
The third day, patient has been visited by the counselor and repetition of lactation counseling material. They were being told that breast milk could prevent infection before and after the treatment required in this case, and provide better results than formula milk. The counselor also told them how to use Haberman feeder and how to wash it. The infant was discharged that day by a pediatrician and was asked for control six days later to the polyclinic.

At the next control the baby’s weight was great, clinical condition was well, Mrs. W feeds baby with Haberman feeder contains breastmilk. And referred to oral surgeon for the management of his cleft lip.

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