The cleft makes it difficult to get suction on the nipple.
Some mothers can use their breast to fill the cleft and allow the infant to nurse.
Some mothers have been able to express breast milk and feed it to the baby via the bottle. These babies require close monitoring of their growth. Down's Syndrome Infants with Down's Syndrome often have a poor suck and hypotonia. They may have difficulty stimulating the maternal breast enough in order to get the milk supply up. Consequently, they may need some supplemental feedings using a supplemental nursing system and they need close monitoring regarding their weight gain.