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Expert Q&A:
How can I teach my 1-year-old, who has a cleft palate, to drink?

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Suzanne Dixon
Answered by Suzanne Dixon M.D., M.P.H.
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"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Question


My 1-year-old daughter has a cleft of the soft palate and we are having some problems teaching her to drink from a sippy cup and straw. She just doesn't know to suck. She has been using a special nipple (Medela Haberman) since she was about a week old. Do you have any suggestions? She will have surgery to correct the cleft in a few months.

Answer


It is difficult to advise you exactly as I don't know the size of the cleft in her palate, whether the lip is involved, and how much control she has over the muscles of her mouth and throat. If she gets liquid up her nose every time she tries to use a cup, she will resist doing it. The straw may be even harder as it requires that she make a vacuum in her mouth, and that may be impossible until the surgery corrects the problem. I think you will be surprised at how fast she catches up after the procedure. Meanwhile, keep her nutrition up with the special bottle feedings so she is in good shape for the procedure. I hope you are also keeping good track of her ears and her hearing as this is usually an additional issue that we have to address with children with cleft palate.
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