Cleft lip and Cleft palates are among the most common birth defects. While the fetus is developing in the mother’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 are at higher risk of developing ear and respiratory infections.
What is a Cleft Palate?
A cleft palate is an opening between the two sides of the palate as shown.
Repair of cleft-lip
Can be done 48 hours after the baby is born.
Repair of cleft palate
Cleft palate surgery is usually done within the first or second year of the baby’s life. This allows a period of time in which the baby’s mouth can mature, but cleft palate plastic surgery should be done before the baby starts talking.
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 whilst the baby is feeding.
Babies with only a cleft lip may have a better chance at breastfeeding. The mother can sometimes close the hole to make a seal with her hands, while her baby is breastfeeding.
Unfortunately some babies may need to drink via alternative methods until their cleft has been fixed.
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 the mother’s milk or donor milk, if possible.
• Breast milk provides support for the immune system, which will reduce the incidences of ear infections (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 the baby from these infections.
• It is imperative that the breastfeeding relationship is helped on by a lactation consultant.
• Trying different breastfeeding positions, can help the mother find one that is comfortable and easiest.
• Upright breastfeeding positions can help keep the milk form running into the baby’s nose.
• Mom may need to support her 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 the baby’s
mouth to give shape to the palate. The Obturator can help the baby suck
stronger and provides firm pressure on the breast. The mother should request
that the Obturator be made of a smooth surface, as not to hurt her while
Breast Feeding Cleft Palate / Lip Babies – Other Tips
• Keep an eye on the milk transfer. The signs that your baby is getting in enough milk.
A mother 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 your baby accustomed to the breast, so that your baby is more likely to breastfeed after surgery.
• Haberman bottle: This bottle helps regulate the flow of milk into the 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 a baby while continuing to breastfeed at the same time. Read more here about SNS.
Can cleft lip/palate be avoided during pregnancy?
• Mothers should be taking at least 400mcg Folic acid per day, especially during the first trimester.
• Mothers should avoid certain drugs such as epilepsy medication, steroids, anti-inflammatory meds, alcohol and cocaine.
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
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