Infants with orofacial clefts are challenging to feed. Babies with cleft palate may be unable to create negative pressure to remove milk from the breast. In-utero motor patterning of tongue movements and swallowing is often altered. Lactation consultants can help mothers protect milk production and assist the infant in being as active a participant in feeding as possible. Some families may choose special bottles, others may use modified supplementers to feed their infant at breast to promote normal breastfeeding after repair. This presentation reviews strategies and tools to promote normal tongue and swallowing function in infants with clefts.