Improving Feeding Outcomes for Babies with Clefts


The feeding team of the center was developed to support the needs of the approximately 75 newborns who enter the Cleft Lip and Palate Center each year and the families that care for them.

Babies with cleft palate are at risk for FTT because they expend too much energy trying to feed,” explains Courtney Hall, MS, CNP, pediatric nurse practitioner and clinical leader of the feeding team. “They expend more calories than they can consume with each meal.”

“Feeding a new baby can be stressful, even when there are no physical barriers,” says Adriane Baylis, PhD, CCC-SLP, speech scientist and quality improvement leader of the feeding team initiative. “For babies with cleft palate, feeding is the primary focus and stressor for families in the early months of life.”

Babies with cleft palate are rarely able to breastfeed directly to meet their nutritional requirements, and in some cases, children may need fortification of expressed breastmilk or formula to increase caloric density. Special nipples and bottles have been developed for infants with cleft palate to help deliver nutrition more efficiently. But even so, feeding problems can persist and parents may need additional medical support or resources to navigate them successfully.

Before the launch of the multidisciplinary feeding team and concentrated efforts around staff and patient education, the rate of FTT among nonsyndromic infants with cleft palate at the hospital was approximately 18 percent.

"Upon the conclusion of the quality initiative, the rate of FTT among nonsyndromic patients with cleft has been sustained at 5 percent. The success of this effort reflects the collaboration and dedication of all feeding team members."

Speech Scientist at Nationwide Children's