A baby feeds by a combination of two main techniques: sucking and squeezing. To be able to generate suction in the mouth, the baby needs to be able to close the gap at the back of the throat between the nose and mouth. If there is a cleft palate, the baby is unable to close that gap, and whenever he or she tries to suck the milk, air leaks from the nose into the mouth through the cleft.
The other way a baby feeds is by squeezing and stimulating the nipple to release milk. A baby does this by pushing his or her tongue up against the nipple and squeezing it against the roof of the mouth. If the baby has a cleft palate, the roof of the mouth has a gap, so there is nothing for the baby to push the nipple against.
Since a baby with a cleft palate can’t generate good suction in his or her mouth and can’t stimulate a nipple as effectively as a baby without a cleft palate, it is normally necessary to help with feeding by using specialized bottles and nipples.
While we encourage breastfeeding for many emotional and psychological reasons, breastfeeding alone will, most likely, not give your baby with a cleft palate the amount of milk that he or she needs to grow well. If you wish to keep the health benefits of breast milk, it is certainly possible to feed your baby with your breast milk, but you will need to express the milk with a pump and then give it to your baby through one of the specialized bottles and nipples. Please see the section of the website on cleft palate feeding for more information.
After the palate is repaired, children with cleft palate generally no longer have problems feeding. However, if there is still a hole in the palate, or if the soft palate is not working as well as it should, then some foods and liquids – especially milk, juices, yogurt and chocolate – can spill from the mouth into the back of the nose and leak out through the nose. Sometimes, children become very good at controlling this, but often further surgery is recommended.