Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy and are called “orofacial clefts”.
What is Cleft Lip?
The lip forms between the fourth and seventh weeks of pregnancy. When a baby develops during pregnancy, body tissue and special cells from each side of the head grow toward the center of the face and join together to make the face. The joining of tissue forms facial features such as the lips and mouth. A cleft lip happens if the tissue that makes up the lip does not join completely before birth which results in an opening in the upper lip. The opening in the lip can be a small slit or it can be a large opening that goes through the lip into the nose. Children with a cleft lip can also have a cleft palate.
What is Cleft Palate?
The roof of the mouth (palate) is formed between the sixth and ninth weeks of pregnancy. A cleft palate occurs if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. Some babies may have both the front and back parts of the palate open or may have only part of the palate open.
Representation of the most common types of cleft affecting the lip and palate.
(© Copyright Brito, Meira, Kobayashi, & Passos-Bueno, 2012).
Children with a cleft lip with or without a cleft palate or a cleft palate have problems with feeding and speaking clearly and may have ear infections.
Management & Treatment
Surgery is recommended within the first 12 months of life for a cleft lip and within the first 12 months of life or earlier for a cleft palate. Special dental or orthodontic care and speech therapy may also be appropriate.
Orofacial clefts are diagnosed during pregnancy by a routine ultrasound or after the baby is born.
Tips for Feeding Your Baby
Feeding issues are among the first concerns following the birth of a child with cleft lip and/or palate. It is crucial to ensure adequate and efficient intake for appropriate hydration and nutrition, for growth and development, and for adequate medical status, especially if considering surgery. Here are some tips for feeding babies with clefts:
Hold your baby in an upright position on your lap and tilt him/her back slightly . This will help the baby swallow while preventing milk/formula from flowing into the nose or ear.
Rub the nipple of the bottle on the lower lip to help place the nipple into the mouth. This will start the sucking reflex.
Use specialty bottles: you should hold the bottle during the whole feeding time. The bottle should not be propped by a pillow or other item during feeding. This is not safe for your baby and can cause choking.
Burp your baby often (after every 1/2 to 1 ounce). Babies may swallow air during feeding.
If you put your baby to bed after feeding, place your baby on their back.
It is expected to see some milk leak out of the nose during feeding. It does not indicate your child is choking. To help with this, keep your baby more upright during and after feeding. If your baby is coughing or has labored breathing they may be getting too much milk. If you notice these signs, contact your healthcare team.
CDC Facts about Cleft Lip and Cleft Palate
Nationwide Childrens- Cleft Palate: Feeding Your Baby
Information on the Impact to Speech and Feeding
Written by Jasmine Hou, OTS
Jasmine is currently a Doctoral Occupational Therapy Student at the University of St. Augustine in San Marcos, previously having graduated from Azusa Pacific University with a Bachelor’s degree in Allied Health and a minor in Psychology. Jasmine loves spending time with her family and friends. She enjoys playing guitar, exploring the outdoors, and playing with her dog and cat.
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