Many a times, we observe that, new born babies have a split upper lip or roof of the mouth or both. This is called as Cleft lip & cleft palate respectively. These account for the most common birth defects. They are either seen as isolated birth defects or are found to be associated with other inherited genetic conditions. Apart from its cosmetic implications, it causes a hindrance to breastfeeding. Mothers need to be counseled and educated on the right techniques of breastfeeding in such scenarios.
Isolated cleft lip may not significantly affect breastfeeding. Cleft lip can be unilateral or bilateral. If the cleft lip is partial it is easy to plug or seal cleft lip. The mother holds the infant close to her breast draws the breast tissue between her fingers similar to grasping the handle of a tea cup and presses into the gap in the lips. This is called TEACUP hold. The mother may also place the finger over the cleft to create a seal. If the cleft extends into the nasal cavity, it’s difficult.
Sometimes it can simply be a sub mucus cleft palate .this is often noticed by nasal regurgitation (while feeding the breast milk is seen to come to out of the baby’s nose. In such cases the mother should be taught to hold the baby in upright position to prevent the baby from choking. She can support the weight of the breast in her hand and use breast compression technique to help transfer of milk to the baby.
As these babies may not be able to form a tight seal on the breast and create proper vacuum, they need supplementation. The mother can do hand expression as well as use a breast pump. Feeding of this milk can be done with a feeding device known as Haberman’s feeder.
The babies who are given formula are at high risk of developing Otitis media. As far as possible, mothers should be encouraged to give expressed breast milk. Also, the mother should be encouraged to put the baby to the breast in an upright position. The baby’s weight must be monitored.
These babies can be operated at 3-6 months of age. After operation most of the times, they can latch very nicely to the breast and gain optimal benefit of breastfeeding.
Inputs from:
Dr. Shama Jagadish Kulkarni
M.B.B.S, D.C.H, I.B.C.L.C, Developmental
Adolescent’s and Lactation Pediatrician
Jagadisha Child Guidance and Lactation Management Clinic
