Cleft Lip Breastfeeding

Cleft palate and cleft lip breastfeeding advice

What is a cleft palate? A cleft palate is an opening in the inside of a baby’s mouth, that starts in the hard or soft palate and ends at the nose entrance. Actual Breastfeeding with cleft palate is not always possible, depending on the severity.

What is cleft lip? A cleft lip is an opening from the lip, upwards and can occur more than once on either side of the lip. Cleft lip is also sometimes referred to as “harelip". Cleft lip breastfeeding is important for mouth muscle development.

More pictures here.

Mothers that have a baby with a birth defect like cleft lip or palate, should know that breast milk is even more important to their babies, since these babies in particular are more inclined to get infections.

Cleft lip breastfeeding is easier than breastfeeding babies with cleft palates. But that doesn’t mean that you can't breastfeed a baby with a cleft pallet, you can still pump your breast milk and feed it to your baby in special cleft palate bottles that have a cross cut nipple, or you can feed your baby via alternative feeding methods like cup feeding or  lactation aids.

Some babies with these problems might choke a lot during feedings and may also leak the milk from their noses. Babies with cleft pallets will almost always need to be fed via bottle to supplement as they usually don’t get in enough milk during breastfeeding. Some babies have cleft lip and palate simultaneously and are usually fed with a special sippy cup or are breastfed sitting up. A cleft lip palate combination can be very frustrating for mothers who are trying to breastfeed, and support and help can be found at a cleft palate clinic, where cleft lip and palate treatment is superior.

The actual process of breastfeeding can help strengthen a baby’s face and mouth muscles, which can enhance speech skills. Breastfeeding with a cleft lip is also more practical for a baby with a “hare lip", as baby will have more control over the milk flow than with a bottle.


Cleft lip and Palate Surgery

Cleft lip repair and cleft palate surgery are recommended as soon as possible and no later than the age of three, because of developmental factors.

Cleft lip surgery usually takes place within the first 10 weeks of a baby’s life. Cleft lip treatment after surgery usually entails the baby wearing a head bonnet and splints to restrict his/her arms, this is just so that the baby doesn’t touch or damage the stitches.

Cleft palate repair will close the opening between the nose and mouth, which will help with breathing, swallowing and normal development of the baby’s mouth. With a repaired cleft palate, the baby will be able to start breastfeeding normally again.

Here is a site that gives the cleft palate care dos and don'ts after cleft palate surgery.


The Challenges

  • Baby chokes and gags while breastfeeding.
  • Not being able to latch on correctly.
  • Milk leaks from the nose.
  • A weak suck.
  • Baby might swallow too much air during breastfeeding.
  • Baby might not be able to stay on the breast long enough, since he/she becomes tired quickly.
  • Baby might want to only breastfeed on the “good side" of his mouth.
  • Baby sometimes takes longer to feed.
  • Cleft palate babies sometimes struggle to breathe.
  • Baby gains weight very slowly. These problems usually results in slow weight gain, regardless of whether they are breastfed or bottle-fed.
  • Ear infections are common.
  • Baby has colic symptoms. Read more about colic here.


The Solutions to some Problems  
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Cleft palate and Cleft lip Breastfeeding

  • The football hold or straddle (Australian hold) can help prevent chocking and leaking milk from the nose.
  • If the baby has a preference for which side of his mouth to breastfeed from, then you can always breastfeed him/her in the cradle position and then slide him/her over to your other side in the football hold position. This is so that you do not always have to breastfeed your baby from one breast alone.
  • If your baby is very weak and keeps falling asleep while you are breastfeeding, you can try waking him by wiping his feet with a damp cloth. You will need to wake your baby at least 8 times, every 24 hours to breastfeed.
  • If  your baby does not empty your breast during a feeding, you might have to pump afterwards to make sure that your milk supply does not decrease. Increase your milk supply.
  • How do you know if baby is sucking sufficiently? You will feel a deep pulling sensation at your breast, while baby is drinking. A baby that is sucking well, will have jaw, ear and temple movement.
  • If your baby has the cleft on the side of his/her mouth, sometimes it will be easier to breastfeed the baby with the cleft side against the breast, this will cause a better seal.
  • You will need a hospital grade, electric breast pump, especially if your baby has a cleft palate. Some Moms decide to pump exclusively.
  • You will need to burp your baby more often, as he/she might swallow more air than normal.
  • Babies with a bilateral cleft lip (a cleft that occurs on both sides of the lip) will need to be breastfed sitting up, or in the football hold position.

What is a Palatal Obturator?

It is a device that is fitted especially for each baby and covers the open area, therefore, making feedings much easier. It covers the open nasal cavity, which causes the leaking and choking during feedings.


Causes of Cleft Lip & Cleft Palate Causes

  • These birth defects are due to the tissues not fusing in early development, in the womb.
  • 1 in every 600 babies have a cleft lip or cleft palate.
  • Cleft lip and cleft palate are more common in Asians, less common in whites and least common in black people.
  • Cleft lips and palates are often found to be inherited. Cleft lip & cleft palate genetic occurrences are found to be more common in boys than in girls.

Environmental risk factors may increase the risks

  • A mother who smokes during pregnancy, doubles the chances that her child will be born with a cleft lip & palate.
  • Drinking while pregnant (alcohol).
  • Being overweight while pregnant.
  • Lack of Folic acid during pregnancy.


Will a Cleft Lip or Cleft Palate affect Speech? 

No, but your baby might just take a little longer to learn to talk. Cleft palate speech therapy is available to children who struggle a little later with their speech development.


What is a Submucous cleft palate?

A submucous cleft palate is not as obvious as a normal clefting. It’s covered by a membrane and sometimes never causes any problems, but there is still a risk of ear infection. A submucous cleft can be found in the hard or soft palate.


One Mother's Story and Advice...


If your baby is born with a cleft palate or cleft lip, talk with a lactation consultant in the hospital for cleft lip and palate support as soon as possible.

For more cleft palate information or information on cleft palate operation


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