Cleft lip and palate affect thousands of infants and children in the United States each year. In fact, the Centers for Disease Control and Prevention (CDC) estimates 7,000 babies will be born with a cleft this year, but there is not a lot of awareness about cleft lip or palate and how it affects feeding. July is national cleft and craniofacial awareness/prevention month and we are celebrating how feeding can be successful for these infants and toddlers!
Babies with Cleft Lip: Babies who are born with a cleft lip have a split or separation of the lip, and sometimes have a split of the bones in the upper jaw and gum. These babies have trouble with feeding because it is hard for them to make a good seal around the nipple to successfully draw out milk.
Babies with Cleft Palate: Babies who are born with a cleft palate have an opening in the roof of the mouth. These infants struggle with feeding because the mouth is not closed off from the nose, which makes it hard to create suction and draw milk out.
Therapy Summary: With coaching from a feeding team, including a speech language pathologist, most children with cleft lip and/or palate can learn to feed safely and easily. In my experience, feeding and swallowing therapy for a child born with cleft lip and/or palate begins at birth and may continue to about 8 years of age. The baby with cleft palate will require specialty bottles and feeding techniques, especially during the cleft lip and soft palate repairs. The toddler may have increased food refusal particularly after the hard palate repair or pharyngeal flap (if indicated). The school age child may have extreme picky eating after the alveolar bone graft or orthodontics is introduced.
Therapy Tips: Toddlers and children who have had surgeries for their cleft lip and/or palate may continue to have a feeding disorder because feeding may have been uncomfortable or painful. Some tips to help these children succeed in feeding are to:
- Establish: It’s important to establish safe feeding behaviors early. At 6 months of age introduce a soft plate like the Mini Mat so that the baby can be exposed to the milk or food in the plate. The Mini Mat is a soft silicone plate that is perfect for kids to gum, lick and chew on.
- Eat: Your child’s doctor may place your child on a special diet after each surgery depending on their skill, age and development. Some doctors may allow or deny breast, bottle, syringe, cup or straw feedings. And others require a diet of clear liquids or soft foods like yogurt, gelatin and purees.
- Energy: Your child will be in a lot of doctor and therapy appointments while preparing for surgery and after surgery. Their energy will be lower and their mealtime appetite may decrease as well. Be aware that this is normal and bring any concerns you have to your child’s medical team.
Join our team in recognizing national cleft and craniofacial awareness/prevention month by sharing this post. Let's spread the news that feeding can be a positive experience for these kiddos and their family! #ezpzfun #cleftawareness
Dawn Winkelmann, M.S, CCC-SLP
Speech Language Pathologist & Feeding Specialist for ezpz