Cleft Lip And Palate

Cleft lip and Cleft palate are among the most common birth defects. While the fetus is developing in Mom’s womb, the lip and palate fuse together. If they do not fuse together, it results in this deformity which can be minor or severe and may even affect the entire palate and/or nose.

Of all babies who are born with this defect, a third have only a cleft lip, another third have only cleft palates and the remaining third have cleft palate with cleft lip.

Babies with cleft palates have a higher risk of developing ear and respiratory infections.

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What is Cleft Lip?

A cleft lip is an opening between the two sides of the upper lip as shown.

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What is a Cleft Palate?

A cleft palate is an opening between the two sides of the palate as shown.

This picture is of a cleft lip and cleft palate combination.

Cleft Lip and Palate Treatment

Repair of cleft-lip

Can be done 48 hours after baby is born.

Repair of cleft palate

Cleft palate surgery is usually done within the first or second year of baby’s life. This allows a period of time in which baby’s mouth can mature, but cleft palate plastic surgery should be done before baby starts talking.

The impact on breastfeeding

During breastfeeding, the lip and palate help create suction that is necessary to pull the milk from the breast. If the lip and palate are not formed properly, the suction is insufficient and in some cases it can be nearly impossible to breastfeed.

A cleft palate can cause milk to flow into the nasal passages, which may cause choking while baby is feeding.

Babies with only a cleft lip may have a better chance at breastfeeding, as Mom can sometimes close the hole to make a seal with her hands while breastfeeding.

Unfortunately some babies may need to drink via alternative methods until their cleft has been fixed.

Cleft Lip Symptoms

Common breastfeeding problems encountered

•    Babies with cleft lip/palate usually take much longer to feed.

•    Babies with cleft lip/palate problems usually need supplementation and this is preferably Mom’s milk or donor milk if possible.

Why is Breast Milk Important?

•    Breast milk provides support for the immune system which will reduce the incidences of ear infection (babies with clefts are more prone to ear and respiratory infections)

•    Breast milk will help prevent hearing, speech and language problems that are linked with ear infections. (cleft palate speech therapy is often needed )

•    Surgery on it's own comes with the risk of infections and breast milk can help protect baby. Read more on the immune protection of breast milk.

Making Breastfeeding Easier

•    It is imperative that the breastfeeding relationship is helped on by a lactation consultant.

•    Trying different breastfeeding positions can help Mom find one that is comfortable and easiest.

•    Upright breastfeeding positions can help keep the milk form running into baby’s nose.

•    Mom may need to support baby’s jaw and chin while latching and keeping a position at the breast.

•    Using a Palatal Obturator: This is an appliance that fits into baby’s mouth to give shape to the palate. The Obturator can help baby suck stronger and provides firm pressure on the breast. Mom should request that the Obturator be made of a smooth surface, as not to hurt her while breastfeeding.

Breast Feeding Cleft Palate / Lip Babies – Other Tips

•    Keep an eye on baby’s milk transfer. Read more on how to know if your baby is getting in enough milk.

•    Mom should express her milk after feedings to drain the breast well. This will help stimulate milk production. She should use a hospital grade, electric, double action breast pump if possible.

•    Keep baby accustomed to the breast, so that baby is more likely to breastfeed after surgery.

Supplementing a Baby with a Cleft Lip/Palate

•    Haberman bottle: This bottle helps regulate the flow of milk into baby’s mouth.

•    Cleft palate nursers: These are bottles made especially for babies with cleft palates.

•    A SNS “supplemental nursing system” can be used to help supplement baby while continuing to breastfeed at the same time. Read more here about SNS.

Cleft Lip and Palate Causes / Prevention

Can cleft lip/palate be avoided during pregnancy?

•    Moms should be taking at least 400mcg Folic acid per day, especially during the first trimester.

•    Mom should avoid certain drugs such as epilepsy medication, steroids, anti-inflammatory meds, alcohol and cocaine.

Cleft lip and palate resources

More Cleft palate information and support. 

More Cleft lip information and support.

Breastfeeding baby before and after surgery.

Top of cleft lip and palate page

Tracy Behr, CBC. CLD (CBI)
Reference: Breastfeeding counselor course through Child Birth International on the physiology of breastfeeding, health of baby, baby with cleft lip / palate problems and breastfeeding.

Other pages on breastfeeding problems in connection with this page on cleft lip and palate problems

* Baby with a weak suck.

* Alternative feeding methods.

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Site by BFeeding Mamma, Tracy Behr. Currently studying through Child birth International (CBC, CBD). Also an accomplished author and Mommy of two.

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