In neonatal medicine, pre-term babies with oral malformation are frequently encountered. We report a successful case of cleft lip and palate in an extremely low birth weight female infant, focusing on the feeding strategy. The female infant was born at 28 weeks gestation and weighed 944 g. Immediately after birth, she showed slight respiratory and circulatory distress, sepsis due to her mother's intra-uterine infection, jaundice and anemia, and she was managed in a neonatal intensive care unit. At first she was fed sufficient amounts of mother's and artificial milk with tubing to prevent respiratory complications and to produce steady rates of growth. Also, she received oral care to facilitate sucking. She achieved a body weight gain to 1800 g at the age of 11 weeks and 1 day from birth, and commenced bottle feeding with a P-type nipple. We applied a palatal obturator (Hotz plate) to achieve optimal alignment of the cleft palate segments at the age of 16 weeks. Later, we performed cheiloplasty and palatoplasty under general anesthesia.