Birth Defects

Birth Defects

Some birth defects such as Down syndrome, cleft lip, or cleft palate make it difficult to breastfeed. You can breastfeed babies with these birth defects, but you will need the help of a lactation specialist or someone who has experience with such special cases. When faced with a baby with birth defects, women who are not already dedicated to the idea of breastfeeding are likely to choose formula feeding. Formula feeding may be easier though it may not be better.

Cleft Lip
birth defects and breastfeeding
Cleft lip is a facial deformity where the lip looks like it is cracked. Cleft lip can be mild where the crack is so small that it looks like a small scar. It can be quite sever with the crack extending up towards one or both nostrils. Cleft lip can be repaired with surgery though this usually occurs when the baby is 2 to 3 months of age.

Can a baby with birth defects like cleft lip still breastfeed? If the cleft is minor, then yes. If the cleft is intermediate, then he may be able to breastfeed if the mother pinches the cleft closed with her fingers. By closing the crack, he may be able to get a good seal which is needed to effectively suck from the breast.

If the cleft lip is very sever, then it would be very challenging to breastfeed. Some problems that a baby with cleft lip may encounter:


  • milk may come out of his nose instead of down his throat (baby),
  • more ear infections (baby),
  • poor speech development (toddler),
  • low self esteem and the feeling of alienation (older child).

Mothers who are exhausted from labor, or distraught by not having a “perfect baby”, may choose formula feeding simply because it seems easier. The challenges of feeding Baby can be shared with another adult, instead of the mother shouldering all the work and worry.

Advocates of breastfeeding will argue that breast milk up Baby’s nose is less irritating compared to formula up his nose. And, the antibodies found in breast milk would be prevent ear infections. Though this may be true, one has to balance the benefits of breastfeeding to baby with the anxiety that mother may experience.

Perhaps an agreeable alternative to formula feeding is for a woman to express her breast milk. The expressed milk can then be placed in a bottle or in a cup. This way, she can give Baby the benefits of breast milk and side-step some of the problems associated with breastfeeding a baby with cleft lip.

Get help from a support group such as

    – La Leche League
    – Clef lip and palate association (in the UK)
    – FACES: The National Craniofacial Association
    – AboutFace International

Cleft Palate
cleft palate and breastfeeding

Cleft palate is similar to cleft lip; but the crack is at the roof of the mouth. The crack can be just in the mouth, or it may extend from the roof of the mouth towards one or both nostrils. Cleft palate may occur in combination with cleft lip.

Cleft lip and cleft palate are genetic defects which occur about one in every 600 to one in every 800 births. In some cases, the condition may be induced by medicines or chemicals: recently, it has been shown that Topamax (anti-convulsion medicine) may cause birth defects such as cleft palate and cleft lip in a developing fetus. Read more here.

With respect to feeding, the problems are the same for babies with cleft palate as those with cleft lip. Again, mothers often opt to formula feed since it appears to be so much easier: you bypass all the problems associated with breastfeeding, and you have greater control as to how the formula is delivered to the baby.

Again, a good option would be to express milk and use this in the baby bottle or cup.

If you do choose to breastfeed a baby with cleft palate, feeding him in an upright position may help. Gravity will help the milk go down his throat instead of the milk going up his nose.

Down Syndrome

Down Syndrome is a genetic disorder where the baby has more than 46 chromosomes. The extra chromosome (called chromosome 21) can be completely duplicated, or only a part of it is duplicated.

People with Down syndrome have numerous characteristics such as lower IQ, shorter limbs, poor muscle tone, and so forth. The severity of the condition varies considerably from one person to the next. Such birth defects occur about one-in-800 to one-in-1000 births. The chances of a woman having a baby with Down syndrome is higher as the mother gets older. By age 49, the chances are one-in-eleven births (admittedly, very few women of age 49+ are still having babies).

Babies with Down syndrome may have poor control over their facial muscles and may find it difficult to suck milk from the breast. Woman who are exhausted or distraught may lose confidence in themselves & their bodies. They may choose formula feeding thinking that formula would be better. But, this is not the case,….

In addition to all the antibodies and nutrients in breast milk to make it the “perfect” food for babies, breastfeeding also allows for skin-to-skin contact which benefits your baby’s emotional state. If you cannot breastfeed your baby, or do not want to, then an alternative would be to express milk and feed it to your baby. You can always give extra cuddles and love in throughout the day. Read this inspiring story about mom with a Down syndrome baby.