Breastfeeding a baby with a cleft lip or cleft palate

Breastfeeding can be challenging for any mom. But, for the mother of an infant with a cleft lip or cleft palate, it can be daunting.

In honor of World Breastfeeding Week, I am featuring a very helpful post on breastfeeding a baby with a cleft lip or cleft palate, written by our March of Dimes blogger and Lactation Counselor. Thank you Lauren, for this post filled with useful, practical tips.

A cleft lip is a birth defect in which a baby’s upper lip doesn’t form completely and has an opening. A cleft palate is a similar birth defect in a baby’s palate (roof of the mouth). A baby can be born with one or both of these defects. If your baby has a cleft lip, a cleft palate, or both, he may have trouble breastfeeding. It is normal for babies with a cleft lip to need some extra time to get started with breastfeeding. If your baby has a cleft palate, he most likely cannot feed from the breast. This is because your baby has more trouble sucking and swallowing. You can, however, still feed your baby pumped breast milk from a bottle.

Your baby’s provider can help you start good breastfeeding habits right after your baby is born. The provider may recommend:

• special nipples and bottles that can make feeding breast milk from a bottle easier.

• an obturator. This is a small plastic plate that fits into the roof of your baby’s mouth and covers the cleft opening during feeding.

Here are some helpful breastfeeding tips:

• If your baby chokes or leaks milk from his nose, the football hold position may help your baby take milk more easily. Tuck your baby under your arm, on the same side you are nursing from, like a football. He should face you, with his nose level with your nipple. Rest your arm on a pillow and support the baby’s shoulders, neck and head with your hand.

• If your baby prefers only one breast, try sliding him over to the other breast without turning him or moving him too much. If you need, use pillows for support.

• Feed your baby in a calm or darkened room. Calm surroundings can help him have fewer distractions.

• Your baby may take longer to finish feeding and may need to be burped more often (2-3 times during a feed).

• It may help to keep your baby as upright as possible during his feeding. This position will allow the milk to flow into his stomach easier, which will help prevent choking.

How breastfeeding can help your baby:

• His mouth and tongue coordination will improve, which can help his speech skills.

• His face and mouth muscles will strengthen, leading to more normal facial formation.

• If your baby chokes or leaks milk from his nose, breast milk is less irritating to the mucous membranes than formula.

• Babies with a cleft tend to have more ear infections; breast milk helps protect against these infections.

If your baby is unable to breastfeed: 

• Feed your baby with bottles and nipples specifically designed for babies with clefts. Ask your baby’s health care provider for recommendations.

If you are concerned if your baby is getting enough to eat, or if he is having trouble feeding, speak with a lactation counselor, your baby’s provider or a nurse if you are still in the hospital.

If you have any questions about feeding your child with a cleft lip or palate, email us at AskUs@marchofdimes.org.