7 Tips For Breastfeeding Babies With High Palates
Breastfeeding a baby with a high palate can be overwhelming, frustrating & painful. Sometimes, learning that your baby has a high palate can be relieving- an explanation for why breastfeeding is so hard & reassurance that it's not just that you're bad at breastfeeding. ( I promise you're not bad at it!) Other times, news of a high palate can feel devastating- yet another thing that makes it feel impossible that you'll ever reach your breastfeeding goals.
In this article, I will offer a few tips that may make breastfeeding your baby easier. These are strategies I use in my practice to help make breastfeeding more manageable. Every baby is unique; Two babies can have the same shape & type of high palate and struggle with different things with breastfeeding. Which tips work for you will depend on what struggles your baby has with breastfeeding & the underlying causes of the challenges. A high palate - or the tongue tie that has caused the high palate- may not be the only thing impacting your baby's breastfeeding.
Though unlikely (and not specific to any particular tip on this list), In some cases, trying to resolve issues with breastfeeding on your own can lead to worsening feeding problems. My best advice is to schedule an appointment with an oral function savvy IBCLC who can help you address ALL the issues leading to stressful or painful feeding in a way that is tailored to your baby's specific needs.
But before we jump right into the tips- First some background information.
What Is A High Palate?
When the roof of the mouth rises higher than usual, it's called a high palate. A high palate typically occurs with a narrow palate. A narrow palate is when the roof of the mouth is less wide than expected.
Providers classify high palates based on the shape of the arching. It's generally accepted that there are three main types of high palate: Bubble, Channel & Vaulted. Realistically, the type of high palate your baby has doesn't matter much, but it may explain what has led to the high arching.
Bubble palates are very common in babies with tongue ties and are the most common shape I see in my practice. Channel palates are most common in babies who had prolonged intubation with endotracheal tubes, who excessively suck on their pacifier or thumb, or who have genetic conditions. Vaulted Palates have a similar appearance to channel palates, but the shape and slope of the arch are a bit different. Vaulted palates, in my experience, are the least common and associated with any one cause.
Once you see lots of high palates, it's easy to identify the differences between the different types.
How Does A High Palate Affect Breastfeeding?
A high palate can affect breastfeeding in many ways. Babies with high palates may:
not be able to generate enough vacuum pressure to remove milk. leading to engorgement, plugged ducts, or weight gain issues.
have a hypersensitive gag reflex not allowing for a deep latch.
constantly click or leak milk
cause significant nipple pain or damage
pop on and off the breast because breathing through their nose is challenging due to small or malformed sinuses
Tips For Breastfeeding Your Baby That Has A High Palate
Do Breast Compressions
Babies with high palates often struggle with slow weight gain. They may eat enough to meet their pee requirements (6-8 wet diapers per day) but may regularly go days without stooling. Slow weight gain or weight loss with infrequent stooling (less than 3-4 x a day in the first eight weeks) is a sign that intake may be a problem.
Because these babies struggle with getting enough to gain well, they also struggle with draining the breast well. Over time, if an adequate amount of milk is not removed from the breast, one's milk supply may drop.
Breast compressions can be super helpful to address both of these scenarios, improving weight gain & breast drainage. When your baby begins to suck, gently compress your breast to encourage milk to flow into your baby's mouth.
Apply Sublingual Pressure To The Soft Spot Under Your Baby's Chin During Feeds
Clicking & leaking are often due to a baby's inability to elevate the tongue to create a proper seal. Sometimes, even in the absence of a tongue tie, clicking and leaking are due to the high palate affecting seal formation.
You can apply gentle pressure to the soft spot under your baby's chin while they feed to help your baby create a seal. Reducing the clicking and leaking can help with reflux if that's something your baby struggles with.
Use The Flipple Technique
The "Flipple” (aka Flip the nipple/exaggerated latch on) Technique is a great technique to help babies get a deeper latch. Many times nipple pain & soreness are due to shallow latching, which results in the nipple being pressed against the hard palate. Because your baby has a high palate, your nipple stretch in unusual and painful ways as it's compressed against your baby's palate.
The idea behind using the Flipple Technique is that if we can get your nipple close to where the hard and soft palate comes together, your baby won't be able to compress the nipple as much.
This technique is not suited for babies with hypersensitive gag reflexes, as the attempts for deep latching may lead to breast refusal. If your baby cannot get a deep latch or stay latched deeply, it's a sign that they physically are unable to and will need tailored lactation support to develop the skills.
Offer The Breast Often
"Offer the breast often" may hardly feel like a tip at all, but because of the challenges some babies with high palates have with feeding, offering the breast often can help increase the total amount of milk your baby gets per day. For a baby struggling with weight gain, every extra ounce of intake can be helpful.
Address Tongue Tie Or Oral Dysfunction
Roof-of-mouth tongue placement is critical for proper palate growth. Babies with tongue tie or oral dysfunction are typically unable to move their tongues appropriately. They may not have the strength or mobility to keep their tongues suctioned to the roof of their mouth. Without addressing tongue placement, it's near impossible to fully resolve a high palate & prevent future dental issues.
Not always is a tongue tie release necessary, and there's definitely a lot to consider with tongue tie surgery regarding the risks & potential complications, but if a tongue tie is the cause of your baby's high palate, it's likely also to be affecting breastfeeding.
Work With An Oral-Function Savvy IBCLC To Desensitize The Gag Reflex
If your baby has a sensitive gag reflex, addressing that is the first, most crucial step to making breastfeeding easier. Together with an IBCLC, you can safely desensitize the gag reflex without the risk of creating oral aversion.
Work With A Craniosacral Therapist To Help Broaden The Arch
There is no research on cranial sacral therapy and high palates that I could find, but from my professional knowledge & experience, it can be highly beneficial. Cranialsacral Therapy focuses on releasing the tension of the fascia of the head, face & neck, which would be tight due to or causing strain to the high palate. Results from CST are not typically immediate though many parents report noticing some improvement soon after the session.