Answer:
Patients with isolated cleft lip may breast-feed before and after surgery. Those with an associated palatal defect are often discouraged since it is thought that they are unable to generate enough force through sucking to adequately nurse themselves. In these patients, parents are taught to bottle-feed prior to surgery using a nipple in which the hole has been enlarged to allow formula to run out directly into the mouth (with frequent pauses to avoid overfilling of the oral cavity). Although traditionally breast feeding was thought to cause strain on a cleft lip repair, anecdotal reports in recent years have suggested that breast feeding does not cause problems to the repair and instead may give significant nutritional benefits with more rapid weight gain over those fed by cup or syringe alone.