Breastfeeding can be challenging for mothers. But, for the mother of a baby with a cleft, the process can be even more daunting. 

A cleft occurs when the lip and/or roof of a baby’s mouth (which is made up of both hard and soft palate) does not fuse together properly during foetal development, leaving a gap. Unfortunately, many babies will encounter problems when it comes to breastfeeding, due to the gap in their lip or mouth can affect their ability to latch onto the breast and suck – two actions which are vital for feeding.   

In honour of International Breastfeeding Week which recently taken place, our president and CEO at Smile Train, Susannah Schaefer, has teamed up with Sarah-Jane Hingorani – Founder of a one-stop-shop for breastfeeding clothing and products – to share some expert insight into breastfeeding and advise on how mothers can look to carry this out successfully if their baby has been born with a cleft:

WHAT IS BREASTFEEDING?

Sarah-Jane Hingorani said:

“Breastfeeding is the feeding of babies and young children with milk from their mother’s breast. It usually begins within the first few hours of a baby’s life and continues as much as the baby or mother wants.”

Susannah Schaefer said:

“Many health professionals recommend that you breastfeed for the first 6 months (26 weeks) of your baby’s life. After that, introducing baby-friendly foods alongside breastmilk is encouraged, as it will help your baby to grow and develop healthily.”

WHAT ARE THE BENEFITS OF BREASTFEEDING?

Sarah-Jane Hingorani said:

“Nourishing your baby from the offset is crucial for their development. A woman’s breastmilk is extremely beneficial for babies as it contains a plethora of vitamins, minerals and bacteria that will help them to grow and remain healthy.”

Susannah Schaefer said:

“In addition to its nutritional benefits, breastfeeding can also reduce your baby’s risk of developing unwanted health problems – such as:

Breastfeeding and making breast milk can have health benefits for the mother too – including a lower risk of developing breast cancer, ovarian cancer, osteoporosis, and cardiovascular disease.”

HOW CAN BREASTFEEDING HELP ME TO BOND WITH MY BABY?

Sarah-Jane Hingorani said:

“The adjustment to motherhood can be very daunting and often mothers have concerns about their ability to bond with their newborns quickly. Closely linked with the ‘baby bonding’ process, is breastfeeding.

“Bonding is an emotional and psychological process, based on the love, trust and interdependency that takes place between a parent and their baby – and the amount of bonding that happens between a mother and their baby through breastfeeding is immeasurable.

“The exchange in milk not only provides the nutrients that babies need in order to survive and thrive, but it also creates hormones that release feelings of wellbeing and happiness for the mother.”

WHY IS IT DIFFICULT TO BREASTFEED WITH A CLEFT BABY?

Susannah Schaefer said:

“Approximately 1 in 700 babies are born with a cleft lip and/or palate each year globally. (That’s around 1,200 babies in the UK.)

“One of the biggest challenges faced by mothers who have given birth to a baby with a cleft is feeding them. Many babies with clefts will encounter difficulty breastfeeding because they lack the ability to suckle efficiently. This is because the split in the lip and/or mouth may affect the normal action of sucking or swallowing that is vital for feeding.

“As a result of this, babies with clefts can struggle to receive the right amount of nutrients from birth – so learning how to feed them properly is key!”

HOW CAN I SAFELY BREASTFEED MY BABY WITH A CLEFT?

Susannah Schaefer said:

“If you and your family have made a commitment to breastfeed your child, the presence of their cleft should not deter you from trying – as it can be possible with some practice and perseverance.

“As a first step, see if your breast is able to mould to your child’s cleft gap. The smaller and narrower the gap is, the less challenging breastfeeding will be – as it will be easier for the baby to grip hold of the breast, and there will be less room for milk and air to pass through. Remember to stop often to burp the baby, as babies with a cleft often take in more air as they feed.

“In some areas around the world, parents do not have access to the expertise or resources needed to support them with their child’s nourishment – which is why, at Smile Train, we have established our special Nutrition Grants programmes. Through these programmes, families are shown how to properly feed their child and adhere to sanitisation guidelines by local health professionals. This ensures that these children are strong enough to safely and successfully undergo cleft care treatment.”

WHAT CAN I DO IF BREASTFEEDING ISN’T AN OPTION?

Susannah Schaefer said:

“If breastfeeding is not an option, there are lots of other feeding methods for you to try, such as expressing breastmilk and giving it by other means. These include:

  • Bottle feeding – You can still feed your baby breast milk but try using a bottle instead. Much like with breastfeeding, the opening between the mouth and the nose can create difficulty for infants with clefts when trying to bottle feed – so you need to be very vigilant. You should try feeding the baby in a more upright position, as this can help to prevent nasal regurgitation. Other options include using speciality feeding bottles or bottle liners to control the flow of the milk when it comes out of the bottle.
  • Spoon feeding – Not many children with a cleft lip and/or palate have long-term problems with eating purees or table foods using a spoon. If your child consistently rejects the idea of spoon-feeding or cup drinking, they are probably not developmentally prepared to take that step yet – so discontinue and try again in a few weeks’ time when they are ready.

It’s vital for parents to know that effective bonding is not necessarily dependent on breastfeeding and can take place when other methods of feeding are used. The important thing is that the child is held often and nurtured – so if breastfeeding isn’t an option for you, bonding is still achievable.”

Sarah-Jane Hingorani said:

“There’s plenty of products on the market at the moment which can help to make the breastfeeding process a lot easier and more comfortable for you – such as the feeding bottles or bottle liners mentioned above.

“I always advise new mums to connect with other mums on ‘parenting forums’, to see if they have experienced similar challenges and learn if any particular products helped them to overcome this. 

For more information about Smile Train and its Nutrition Grants programmes visit SmileTrain.org.uk