Babies spend much of their time feeding. To feed well, they need to position their lips and tongue around the nipple or artificial teat and create both suction and compression during sucking. When a baby is born with a cleft palate or combined cleft lip and palate sucking is more difficult. However, there are a number of ways to help these babies feed well.
Babies with cleft lip usually feed well. Breastfeeding is possible because the breast tissue fills the gap where the cleft exists, and there are no problems with suction or compression because the palate (roof of the mouth) is intact. Bottle feeding is also possible if this is the preferred feeding method.
Cleft lip
Cleft palate
Babies with cleft palate often look like they are feeding well because the lips and tongue close around the nipple or artificial teat like non-cleft babies and the jaw moves well during sucking. However, most babies with cleft palate cannot generate suction during feeding. The lack of suction makes it difficult (and for some babies impossible) to breast or bottle-feed efficiently. Consequently, feeding is a lengthy (>40 mins) and tiring process for the baby and the baby may not get enough milk to grow and develop well. Help is available to manage these feeding problems (see below).
Some babies in this group only have a very small cleft of the soft palate. These babies may be able to generate suction during breast or bottle feeding just like non-cleft babies. They are able to take their entire breast or bottle feed in 20 to 30 minutes. Modifications to positioning or feeding technique are unnecessary
Some babies in this group only have a very small cleft of the soft palate. These babies may be able to generate suction during breast or bottle feeding just like non-cleft babies. They are able to take their entire breast or bottle feed in 20 to 30 minutes. Modifications to positioning or feeding technique are unnecessary
Cleft lip and palate
When cleft lip and palate occur together the baby will have the same difficulties generating suction during feeding as described above (for babies with cleft palate). In addition, they may also have difficulty compressing the nipple or artificial teat. This is because there is insufficient palate (roof of the mouth) and alveolus (gum) for the tongue to compress the nipple or artificial teat against. Compression is important because it helps baby push milk from the breast or bottle during sucking. These babies also need help to manage their feeding (see below).
Feeding difficulties which may occur
When babies with cleft lip and/or palate feed they may:
have milk escape from their nose during feeding (nasal regurgitation) especially if the flow of milk from the teat is fast;
become windy and need to be burped more frequently;
cough and splutter during feeding;
feed slowly;
fail to gain appropriate weight for age.
Feeding difficulties which may occur
When babies with cleft lip and/or palate feed they may:
have milk escape from their nose during feeding (nasal regurgitation) especially if the flow of milk from the teat is fast;
become windy and need to be burped more frequently;
cough and splutter during feeding;
feed slowly;
fail to gain appropriate weight for age.
Helping babies with cleft lip and/or palate feed Breast feeding
Babies with cleft palate or cleft lip and palate are usually unable to breastfeed due to the absence of suction (and in some cases compression). However, they can be put to the breast for bonding or comfort if the mother wishes. Sometimes they are able to extract some milk simply by compressing the breast between their jaws.
Breast milk is best for babies. When babies can’t feed well directly from the breast mothers may choose to feed their baby expressed breast milk from a bottle. Lactation consultants and maternal and child health nurses are able to provide specific advice and support to new mothers who wish to express breast milk for their baby.
Bottle-feeding
If your baby feeds well from a standard teat or bottle purchased from a supermarket or pharmacy there is no need to use any special equipment. A number of special teats and bottles are available for babies who cannot generate suction and/or compression during feeding. Read the next factsheet: Teats and bottles for information on commonly used teats and bottles
Babies with cleft palate or cleft lip and palate are usually unable to breastfeed due to the absence of suction (and in some cases compression). However, they can be put to the breast for bonding or comfort if the mother wishes. Sometimes they are able to extract some milk simply by compressing the breast between their jaws.
Breast milk is best for babies. When babies can’t feed well directly from the breast mothers may choose to feed their baby expressed breast milk from a bottle. Lactation consultants and maternal and child health nurses are able to provide specific advice and support to new mothers who wish to express breast milk for their baby.
Bottle-feeding
If your baby feeds well from a standard teat or bottle purchased from a supermarket or pharmacy there is no need to use any special equipment. A number of special teats and bottles are available for babies who cannot generate suction and/or compression during feeding. Read the next factsheet: Teats and bottles for information on commonly used teats and bottles
For more information
Cleft lip and/or palate feeding 1 — About feeding your baby
Cleft lip and/or palate feeding 2 — Bottles and teats
Cleft lip and/or palate feeding 3 — Helpful bottle feeding techniques
Cleft lip and/or palate feeding 2 — Bottles and teats
Cleft lip and/or palate feeding 3 — Helpful bottle feeding techniques
Factsheets
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