How do I breastfeed if my baby has a cleft lip or cleft palate

How do I breastfeed if my baby has a cleft lip or cleft palate

A cleft lip is an opening in the upper lip, and a cleft palate is an opening in the roof of the mouth (palate). Cleft lip and cleft palate (orofacial clefts) are birth defects that occur when the upper lip or the palate does not develop completely before birth.

In babies with a normal lip and palate, the seal between mouth and breast creates negative pressure that draws milk out of the breast and down the throat with each suck. Babies with cleft lip or cleft palate may have difficulty getting enough milk out of the breast because they are unable to form a good seal. Working with a lactation consultant can help you overcome these challenges and make sure that your needs and your baby’s needs are being met.

What are the benefits of breastfeeding my baby?

• Breast milk supports your baby’s disease-fighting (immune) system. Breastfeeding can help protect your baby from infections that are common among babies with cleft lip and cleft palate, such as ear infections.
• Cleft lip and cleft palate are often repaired with surgery during your baby’s first months. Breastfeeding can help your baby to stay healthy for surgery and to prevent infections after surgery.
• Breastfeeding is calming and soothing for mother and baby. The skin-to-skin contact allows for intimate bonding between mother and baby.
• The breast is soft and flexible, and it molds itself to make up for for abnormalities of the lip and mouth.
• Breastfeeding allows your baby to have control over the flow of milk. Milk flow can be difficult to control with bottle feeding.
• Formula can irritate tissues in your baby’s mouth and nose.

How do I breastfeed if my baby has a cleft lip or cleft palate – Instructions

• Begin breastfeeding as soon as possible after birth. Early breastfeeding is best for your baby’s health. Work with a lactation specialist to overcome any challenges.
• Be patient and find a way to breastfeed that works best for you and your baby.
• Try holding your baby in different positions while your breast is still soft. It is often easier to feed babies with a cleft palate in an upright position because milk is less likely to leak into the nose.
• Use your thumb or breast to help fill in the opening in the lip. This will help form a seal around your breast.
• If the cleft lip or palate is so large that it prevents your baby from being able to nurse effectively, start pumping your milk right away to keep your milk supply up. This will allow you to feed your baby with breast milk only (exclusive breastfeeding) after he or she has had surgery.
• If your baby cannot latch on well to your breast, use a cup or a spoon to feed him or her breast milk.
• Try using feeding tube devices or specialty bottles with soft, flexible nipples to make sure that your child gets enough milk. Ask your lactation specialist or your health care provider about using these devices. In some hospitals, babies with cleft palate are fitted with a mouthpiece (obturator) that fits into the opening and seals it for easier feeding.

What are some tips for breastfeeding a baby with cleft lip or cleft palate?

• Work with a lactation specialist to find positions, equipment, and breastfeeding strategies that work best for you and your baby.
• Make sure your baby is getting enough milk by counting your child’s wet diapers and bowel movements. Signs that your baby is getting enough milk include:
  • Wetting at least 1–2 diapers during the first 24 hours after birth.
  • Wetting at least 5–6 diapers every 24 hours for the first week after birth. The urine should be clear and pale yellow by 5 days after birth.
  • Wetting 6–8 diapers every 24 hours as your baby grows.
  • Producing a healthy amount of stool:
    • By the time your baby is 5 days old, he or she should produce at least 3 stools in a 24-hour period. The stools should be soft and yellow.
    • By the time your baby is 7 days old, he or she should produce at least 3 stools in a 24-hour period. The stool should be seedy and yellow.
  • Gaining a healthy amount of weight. Talk with your health care provider or lactation specialist about how much weight your baby should be gaining.
• If your baby does not get enough milk from breastfeeding alone, talk with a lactation specialist. It may be possible to breastfeed part of the time and supplement feedings with donated milk or formula.

Contact a health care provider if:

• Your baby is older than 5 days and:
  • Does not seem satisfied after feeding at the breast.
  • Is not producing 5–6 wet diapers every 24 hours.
  • Is not producing 3 stools every 24 hours.
• Your breasts become large and painful (engorged).

Summary

• Babies with cleft lip or cleft palate may have difficulty getting enough milk out of the breast. This is because it is difficult for the mouth to form a good seal around the nipple.
• Work with a lactation specialist to find positions, equipment, and breastfeeding strategies that work best for you and your baby.
• Try holding your baby in different positions while your breast is still soft. It is often easier to feed babies with a cleft palate in an upright position because milk is less likely to leak into the nose.