Editing Cleft lip and cleft palate (section)

==== Breast-feeding ====
Babies with cleft lip are more likely to breastfeed successfully than those with cleft palate and cleft lip and palate. Larger clefts of the soft or hard palate may not be able to generate suction as the oral cavity cannot be separated from the nasal cavity when feeding which leads to fatigue, prolonged feeding time, impaired growth and nutrition. Changes in swallowing mechanics may result in coughing, choking, gagging and nasal regurgitation. Even after cleft repair, the problem may still persist as significant motor learning of swallowing and sucking was absent for many months before repair.<ref>{{cite journal | vauthors = Bessell A, Hooper L, Shaw WC, Reilly S, Reid J, Glenny AM | title = Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate | journal = The Cochrane Database of Systematic Reviews | volume = 2011 | issue = 2 | pages = CD003315 | date = February 2011 | pmid = 21328261 | doi = 10.1002/14651858.cd003315 | publisher = John Wiley & Sons, Ltd | hdl-access = free | hdl = 10072/172084 }}</ref> These difficulties in feeding may result in secondary problems such as poor weight gain, excessive energy expenditure during feeding, lengthy feeding times, discomfort during feeding, and stressful feeding interactions between the infant and the mother. A potential source of discomfort for the baby during or after feeding is bloating or frequent "spit up" which is due to the excessive air intake through the nose and mouth in the open cleft.<ref name=":5" /> Babies with cleft lip and or palate should be evaluated individually taking into account the size and location of the cleft and the mother's previous experience with breastfeeding.<ref name=":3" />

Another option is feeding breast milk via bottle or syringe. Since babies with clip lip and cleft palate generate less suction when breastfeeding, their nutrition, hydration and weight gain may be affected. This may result in the need for supplemental feeds. Modifying the position of holding the baby may increase the effectiveness and efficiency of breastfeeding.