Mom’s Milk Matters to These Special Babies
By Gwen Morrison
When a baby is born with a cleft lip, cleft palate, or both, there are questions as to whether or not the infant will be able to successfully breastfeed. The baby’s ability to nurse will likely be directly related to the degree of malformation. With the help of professionals, each mother should be able to achieve her own idea of success in providing breast milk to their infant.
What is the Difference?
In order to understand the hurdles that babies face when trying to breastfeed with a cleft lip or a cleft palate, it’s important to define them. According to the Cleft Palate Foundation, a non-profit organization whose mission is “to optimize the quality of life for individuals affected by facial birth defects through education, research support and the facilitation of family-centered care,” a cleft lip is a separation of the two sides of the lip. The separation often includes the bones of the upper jaw and/or upper gum. A cleft palate is described as an opening in the roof of the mouth in which the two sides of the palate did not fuse or join together as the unborn baby developed.
The baby’s ability to nurse will likely be directly related to the degree of malformation.
Cleft lip and cleft palate can occur on one side (unilateral cleft lip and/or palate) or on both sides (bilateral cleft lip and/or palate). Because the lip and the palate develop separately, it is possible for the child to have a cleft lip, a cleft palate or both.
“Cleft lip and palate are one of the most common birth defects,” says Denise Archambault, RN, IBCLC, CCE, from the Women and Infants Hospital of Rhode Island. “The biggest difficulty is finding a way to create an effective seal for the baby to transfer and swallow milk appropriately.”
Archambault tells mothers that they should put their new baby to breast as soon as possible while the breast is soft. “It gives her an opportunity to practice different positions,” she says. “The breast is far more flexible than an artificial nipple.”
Often in babies with a cleft lip, a seal can be created by bringing the baby in close and nudging the breast tissue into the cleft, says Archambault.
Amy Mackin, deputy director of the Cleft Palate Foundation, agrees. “Babies with cleft lip only should be able to breastfeed with few, if any, problems,” she says. “In fact, breastfeeding can actually be an easier way to feed these babies because the tissue of the breast can help the baby to create a seal more effectively than would be possible with many bottles.”
According to Cleft Advocate, a non-profit organization designed to educate, inspire and empower families whose lives are touched by cleft lip and palate or other craniofacial anomalies, babies born with a cleft lip only (no palate involvement) are usually able to nurse with little trouble. The difficulty for moms is often in finding a position that makes it easier for the infant to nurse.
“Modified football position or having the baby in a sitting position, straddling mother’s lap can help to prevent choking by working with gravity,” says Archambault. “Trial and error with different positions may help a mother to find what works best for her and her baby.”
Lactation consultants can offer feeding alternatives that can prevent problems with breastfeeding, such as choking from milk leaking through the nose. This can be very scary to a mother, as well as a potential medical concern for the child.
Breastfeeding and Cleft Palate
Babies born with a cleft palate are less likely to breastfeed directly from their mother’s breast. Information on this topic at Cleft Advocate indicates that breastfeeding a baby with a cleft palate is difficult. The palate is what allows for suction, so when there is a hole in it, the suction needed for breastfeeding is compromised.
“Very few children with cleft palate are successful with direct breastfeeding as their sole source of nutrition,” says Mackin. “A good analogy is that of trying to suck through a straw that has a hole in it: You can latch onto it correctly, suck very hard and still not get enough liquid to fill yourself up.”
Mackin explains that these babies tend to burn more calories trying to breastfeed than what they take in. For a baby who is likely preparing for surgery, gaining weight is of utmost importance.
“We strongly encourage mothers of babies with cleft palate who want to breastfeed to start pumping immediately,” says Mackin. “They can provide their babies with breast milk through a special cleft palate bottle. We also encourage Mom to put the baby to her breast for the sense of closeness and suckling it provides.”
Babies who are unable to breastfeed by latching on can still benefit from mother’s milk through alternative methods. Moms should not feel guilty about not being able to breastfeed the traditional way.
“I pumped milk for nine months,” says Kiku Trentlyon of New York City. “My daughter has a bilateral cleft lip and palate, and her first surgery was last December which repaired her lip, gum and nose. Her palate was repaired last July.”
Trentlyon did extensive research prior to her daughter’s birth, having been told of her baby’s cleft lip and palate during her 5th month of pregnancy. “I spoke with some lactation consultants and learned just how hard it would be to try and breastfeed a baby with a bilateral cleft lip and palate,” she says. “So I then educated myself on pumping milk as much as I could, and by the time she was born, I was ready!”
Though Trentlyon says it wasn’t easy, she feels it was well worth the effort. Her daughter has always been very healthy and has had no ear infections, which is rare in the cleft community. “She is just the light of our lives,” says Trentlyon. “Breastfeeding has always been an important subject for me, and I’m glad that I was able to provide breast milk for my baby girl.”
Deborah Oliver, founder and director of Cleft Advocate, encourages moms to learn that there are many ways to provide breast milk to their baby. “We want mothers to know the alternative to traditional breastfeeding methods that will enable them to bond with their baby and provide the excellent nutrition breast milk offers,” she says. “Having a child with a cleft can feel like a loss and be extremely overwhelming. Cleft Advocate offers education and support to families throughout the United States and around the globe.”
Why Breast Milk Matters
According to Archambault, these are the benefits of breastfeeding a baby who has a cleft lip and/or palate:
- Breast milk provides immunities against infection, especially ear infections, for a baby who will have major surgery
- Human milk is less irritating to the mucus membranes of the nose and the gastro-intestinal system than formula
- Breast milk absorbs more readily
- Breastfeeding encourages proper development of the baby’s mouth and face
- The pliability of the breast can help to create a better seal and make it easier for the baby to return to the breast sooner after surgery
- Breastfeeding allows Baby to suck for comfort
- Breastfeeding decreases Mother’s bleeding and allows her to be able to care for a special needs baby
“Learning the dance of breastfeeding is often difficult for mothers and babies,” says Archambault. “The support of knowledgeable professionals and family and friends who have had similar situations is invaluable.”