Key takeaways: Many babies with a cleft lip only can breastfeed, sometimes with positioning help. Babies with a cleft palate usually can’t create enough suction to feed effectively at the breast, so specialty bottles and pumped milk are typically needed. A cleft team, including a feeding specialist, guides feeding and growth.
A cleft is an opening in the lip, the palate (roof of the mouth), or both. It changes how babies feed.
Cleft Lip Only
- Many babies can breastfeed.
- Positioning helps: try holding your baby so the cleft is toward your breast, letting breast tissue fill the gap.
- Use your thumb or finger to help close the gap in the lip, if needed.
- Watch weight gain closely.
Cleft Palate (With or Without Cleft Lip)
- The opening between the mouth and nose makes it hard to create suction.
- According to the Academy of Breastfeeding Medicine’s protocol, most babies with a cleft palate can’t feed effectively at the breast alone.
- Comfort nursing and skin-to-skin are still valuable.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. If you want feeding help you can flip to in the middle of the night, my book walks you through feeding month by month, from the very first latch to the first birthday.
Giving Breast Milk
- Pump 8 or more times a day to build and maintain supply.
- Feed with a specialty bottle designed for clefts.
Specialty Bottles
Specialty bottles let you or the bottle control the flow so your baby doesn’t need strong suction. Examples include squeezable bottles and bottles with one-way valves. Your cleft team will help choose one.
Feeding Tips
- Feed upright to reduce milk going into the nose.
- Burp often, since babies with clefts may swallow more air.
- Keep feeds to about 30 minutes or as advised so your baby doesn’t tire out.
- Expect some milk to come out the nose. This is common.
Your Care Team
A cleft and craniofacial team usually includes surgeons, a feeding specialist, speech therapist, audiologist, and others. Some babies use nasoalveolar molding (NAM) before surgery. Lip repair is often around 3 months and palate repair around 9 to 18 months, but timing varies.
After Surgery
Your team will give feeding instructions after each repair.
Call your baby’s doctor if your baby: isn’t gaining weight, has few wet diapers, coughs or chokes during feeds, or has breathing trouble.
The Bottom Line
Babies with a cleft lip often breastfeed; those with a cleft palate usually need specialty bottles with pumped milk. A cleft team will support you.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- Supplementing Without a Bottle: Cup, Spoon, Syringe, and Finger Feeding
- How to Get a Deep, Comfortable Latch: A Step-by-Step Guide
- Tongue-Tie and Lip-Tie: What Parents Should Know Before Choosing a Procedure
- Combination Feeding: Mixing Breast Milk and Formula Without Guilt
- Feeding Therapy: When Your Baby Needs Help Eating
Sources
- Boyce JO, Reilly S, Skeat J, Cahir P; Academy of Breastfeeding Medicine. ABM Clinical Protocol #17: Guidelines for breastfeeding infants with cleft lip, cleft palate, or cleft lip and palate, revised 2019. Breastfeed Med. 2019;14(7):437-444.
- American Cleft Palate-Craniofacial Association. Feeding your baby. https://acpacares.org
- Centers for Disease Control and Prevention. Facts about cleft lip and cleft palate. https://www.cdc.gov/birth-defects
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
