Ask a Therapist: Cleft Palate & Feeding Therapy


I’ve taken your courses for Down’s syndrome and Assessment and Planning. I’m fairly new to feeding, but am having some success with Down’s clients (thank you and they thank you :).

I just got a 15 month old with cleft on my caseload.  He’s had lip repair and his palate only has a small hole after surgery (will be fixed at 3).  His mother said she used a squirt bottle because he couldn’t suck (and still uses it before he goes to bed).  He can drink from a cup without spilling if it only has a tiny amount in it.  Is there any reason this child could not start using a straw or have more control with a cup with intervention?  His upper lip has no movement for retraction or protrusion, but he does get closure for the /m/ sound.



Thanks for your email. I am so glad you have been using what you learned in the Down syndrome class with success! You should absolutely start working on upper lip mobility and lip rounding with this child!  You may have to work through the scar tissue, and I have found that a vibrating upper lip stretch (one gloved finger under the scar, one outside the lip on top, use a vibrating movement with your fingers through the scar tissue) or a myofascial release.  Then do your upper lip stretch, and mickey mouse /m/. Once you get mobility, start doing single sip cup drinking.

Best of luck and let me know how your client progresses!

Lori Overland

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