Health Care

Breastfeeding Challenges and Craniofacial Conditions

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Being able to nourish your baby naturally is one of life’s precious gifts. And it’s no secret that many women struggle with breastfeeding challenges for a variety of reasons. Moms may face issues with lactation, or there may be something in the baby’s anatomy causing a struggle with breastfeeding, like a craniofacial condition such as a cleft lip or cleft palate. Whatever the reason, know you're not alone, and it can get easier.

We’re here to help you on your journey to nurturing your baby’s whole health. Keep reading to learn more from our craniofacial and lactation experts about what might be causing your breastfeeding challenges and how we can help.

Breastfeeding and Craniofacial Conditions

Breastfeeding involves the ability to create and sustain a vacuum seal and a coordinated sucking, swallowing and breathing pattern. This is a complex process for your new baby. Babies with craniofacial conditions or syndromes may have anatomical and neurological challenges contributing to their difficulties with breastfeeding.

Ivonne Mahavir, a pediatric feeding therapist on our craniofacial team, says, “At AdventHealth for Children, we take a whole-family approach to support mothers and babies through these challenges. We work closely with mothers to create individualized feeding solutions that optimize their baby’s weight gain and growth.”

She adds, “Positional changes, latching maneuvers, specialized feeder nipples, specialty bottles and cup feeding are some interventions that can be started early. However, in more complex cases, surgical intervention may be necessary. Getting help early will put you at ease knowing you have support and someone to guide you through the process.”

Common Signs of Craniofacial Conditions

Some signs are visible, including:

  • A gap in the contours of the lip and nose (cleft lip)
  • A gap inside the roof of the mouth (cleft palate)
  • Tongue or lip tie causing limited mobility (ankyloglossia or maxillary labial frenum)
  • Pigmented growths on the skin (vascular and cutaneous anomalies)
  • Abnormally shaped ears (microtia)
  • Severely small jaw or jawbone (micrognathia)

Other signs are more subtle, including:

  • Irregular head shapes (positional plagiocephaly or craniosynostosis)
  • Minor facial asymmetries (minor clefts, subtle hemifacial microsomia and many others)

Breastfeeding and Lactation Issues

Breastfeeding challenges can occur even without craniofacial conditions. Attending a prenatal breastfeeding class can prepare you for your breastfeeding journey, and seeking help early from a lactation consultant if you have issues can help you be successful.

Here are some common issues that may make breastfeeding difficult, with expert advice on how to overcome them.

Low Milk Supply

Many moms worry about low milk supply, but your body usually makes exactly what your baby needs. However, your breasts must be stimulated frequently in the first hours, days and weeks of your baby’s life to establish an abundant milk supply.

“Insufficient breast milk production on its own isn’t common,” says Angela Szymanski, one of our AdventHealth for Women lactation consultants. She continues, “It’s more likely due to infrequent breastfeeding, supplementing with formula without pumping, an ineffective latch or taking certain medications.

Angela adds, “Working with a lactation consultant is encouraged if you’re concerned about low milk supply. We can evaluate your baby’s latch, perform before and after feeding weights to evaluate how much milk your baby is drinking, help you with pump use and make appropriate referrals if we identify a problem."


As your milk supply increases between 2 and 5 days after delivery, your breasts may become larger and feel heavy and warm, sometimes feeling swollen and uncomfortable.

“This normal breast fullness will gradually disappear in a few days as your body adjusts to your baby's needs,” says Angela. She continues, “However, engorgement can lead to a plugged duct or an infection, so it’s important to try to prevent it before this happens.”

Here are some tips to minimize or prevent engorgement:

  • Apply cold compresses or ice packs for 15-20 minutes after feeding
  • Avoid early use of pacifiers or use of bottles or formula unless medically indicated
  • Breastfeed often; don’t skip feedings or limit your baby's time at the breast
  • Call your lactation consultant if there is no improvement within 24-48 hours
  • Don’t wear clothing that is too tight around your breasts
  • Ensure your baby is properly latched
  • Massage breast(s) during feedings to help your milk flow

Inverted, Flat or Large Nipples

Women's nipples come in all shapes and sizes. If your nipples turn inward or are flat or large, it can sometimes make breastfeeding more challenging. But there many ways to help a baby who is having difficulty latching.

The good news is, “Most babies can breastfeed no matter what mom’s nipple is like,” says Angela.

Expert Care Tailored to You and Your Baby

At AdventHealth for Children, we celebrate every child and family. If your baby is struggling with breastfeeding, reach out to our craniofacial team to see if the struggle is due to a craniofacial or cleft anatomical issue. We’ll work closely with your family to develop a customized approach to care with your baby’s whole health in mind.

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