High arched palate in babies

There are several worries for parents of newborns. The most important of them is every parent's fear that the baby will not breastfeed or take a bottle properly. This is a valid issue for some babies born with a high-arched palate (also known as a high-vaulted palate), given that it’s estimated around 30% of the UK population may be born with one. However, a diagnosis of high-arched palate does not have to imply ongoing eating or speaking difficulties. Continue reading to learn more about high-arched palates and what they may imply for your infant now and in the future.

What is high arched palate? 

Once a baby is born, their palate – the roof of their mouth – continues to be shaped and formed during their first year. When it become high and narrow, this is what doctors class as a high-arched palate (also known as high vaulted palate).  The issue of a high palate is only classed by doctors as a minor anomaly, although it may make it more difficult while breast feeding, namely broken suction, a clicking sound, and discomfort. 
 

How common is high arched palate?

A high palate is considered a common minor medical anomaly, with estimates suggesting up to 30 per cent of people in the US are affected (there aren’t any UK figures but it’s likely that the number of people affected could be similar to that for the US). 
 

High arched palate causes

Some babies have a high and narrow palate because they’re born with a medical condition. For instance, a high palate can be a symptom of congenital conditions including

• Down’s syndrome

• Marfan syndrome

• Crouzon syndrome

• Apert syndrome

• Treacher Collins syndrome

But a high palate can also form in babies after they’re born, sometimes because they have tongue-tie. That’s because babies need to shape their palates naturally with their tongues. If a baby has tongue-tie, their tongue tends to rest most of the time flat on the floor of their mouth rather than at the roof of their mouth. But their tongue needs to be at the roof of their mouth as much as possible to shape their palate. If it isn’t, their palate may develop to be higher and more narrow than normal. 

Other things that can contribute to a high palate include excessive thumb sucking and over-use of dummies and soothers. 
 

High palate symptoms

Whether they’re breastfed or bottle fed, a baby with a high palate may struggle to get enough milk because they have poor suction with the nipple or bottle teat. So the first signs to look out for are similar to those for tongue-tie. If their palate continues to become higher and narrower as they grow and get older, someone with a high palate may develop other symptoms too, including:

• Breathing difficulties (they may, for instance, breathe through their mouth rather than through their nose because their high palate is affecting their nasal cavity)

• Nasal congestion that’s hard to clear (as well as causing mouth breathing this can also increase the risk for upper respiratory infections)

• Sleep problems caused by breathing difficulties (people with high palates may develop obstructive sleep apnea or they may snore, plus they may often have to sleep on their side to breathe well enough to get the oxygen they need)

• Facial structure changes, such as narrowing between the eyes and a downward turning mouth

• Speech difficulties, including speech impediments involving sounds that are made by the tongue making contact with the roof of the mouth

• Dental problems such as swollen gums and tooth decay 

How is a high arched palate diagnosed?

A simple physical examination can also often diagnose a high palate, as in many cases it will be obvious to see the problem just by looking in a baby’s mouth. 
 

High arched palate treatment 

If your baby has feeding problems and you suspect it could be caused by a high palate, speak to your GP or midwife. 

If your baby has a high palate because they have tongue-tie, having a tongue-tie division will usually allow their tongue to become mobile enough to shape their palate correctly. If your baby doesn’t have a tongue-tie division, their dentist may recommend special tongue exercises or – for older children – a device called a palate expander that can help widen the roof of their mouth. 

Meanwhile if your baby has a high palate and is bottle fed, you may find they feed more easily if you use shorter or flatter bottle teats.
 

For more information about breastfeeding 

There’s  plenty of advice available to help you with breastfeeding problems – ask your midwife or health visitor for details, or try calling the National Breastfeeding Helpline on 0300 100 0212. La Leche League (0345 120 2918) and NCT (0300 330 0700) also offer lots of support and advice to breastfeeding mothers both by phone and online. 

Meanwhile find information on a range of children’s health conditions by visiting the children’s health section of our pharmacy health library.

References:

1. Available online: https://patient.info/news-and-features/babies-with-tongue-ties-usually-dont-need-surgery

2. Available online: https://www.nhs.uk/conditions/tongue-tie/

3. Available online: https://www.nct.org.uk/baby-toddler/feeding/common-concerns/tongue-tie-babies

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