Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth does not form properly during pregnancy. Together, these birth defects commonly are called “orofacial clefts”.
What is Cleft Lip?
The lip forms between the fourth and seventh weeks of pregnancy. As 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. This joining of tissue forms the facial features, like the lips and mouth. A cleft lip happens if the tissue that makes up the lip does not join completely before birth. This 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. A cleft lip can be on one or both sides of the lip or in the middle of the lip, which occurs very rarely. Children with a cleft lip also can 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 happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. For some babies, both the front and back parts of the palate are open. For other babies, only part of the palate is open.
How can a cleft cause problems with feeding?
To feed effectively, babies need to be able to form a vacuum inside their mouths and to position their tongues properly. A vacuum is formed by sealing the lips around the nipple or teat and closing the back of the mouth using the soft palate (the roof of the mouth towards the back of the throat).
When this is done right, milk is drawn out of the bottle during bottle-feeding, and during breastfeeding, the nipple stays in the right position on the back of the tongue.
Babies use a natural reflex action involving sucking, breathing, and swallowing to feed, and forming a vacuum is what allows them to suck. Some babies with a cleft aren’t able to form this vacuum because of the gap in their lip and/or palate, so feeding on a regular bottle or a breast is very difficult. It’s like trying to drink through a straw that’s full of holes.
Babies with clefts may swallow more air than normal during feeding due to their difficulty forming a vacuum seal, especially if the flow of milk is either too slow or too fast. They may show this by having a blue ‘mustache’, being extra sleepy, or bringing up some of their feed. If this happens, stopping two or three times during the feed to burp the baby may be helpful. You can also talk to your Cleft Nurse Specialist to see if changing bottles or teats might be helpful.
We will continue to talk about World Breastfeeding week on Common methods to help with feeding a child with a cleft, Oral Hygiene, and other related queries that will affect the growth and development of the baby in our next post which is the 5th part of the World Breastfeeding Week (1st-7th august). For more information about Cleft lip or/and palate surgeries, visit our hospital official website gsmemorialhospital.com.