A high palate in an infant is a variation where the roof of the mouth, or hard palate, is unusually high and narrow. Unlike a typical wide, U-shaped palate, a significantly high palate can affect a baby’s oral functions. This anatomical feature can be present at birth or develop during infancy.
What Defines a High Palate
A high palate is an elevated, often narrower arch of the hard palate. A typical infant’s palate is a wide U-shape, with an average depth of 10 mm and a width of about 32 mm. In contrast, a high palate appears steeper, resembling a V or a skinny U-shape, with a greater vertical distance from the gum ridge to the roof of the mouth.
This variation can arise from several factors. Genetics play a role, with conditions like Down syndrome or Crouzon syndrome sometimes presenting with a high palate. In-utero development is also significant, as the tongue’s movement against the palate normally helps shape and widen it before birth. If the tongue’s mobility is restricted during this period, or after birth due to a tongue tie or prolonged sucking behaviors like pacifier or thumb-sucking, it can contribute to a high, narrow palate. When the tongue cannot rest properly against the roof of the mouth, it misses its natural role in guiding palate development.
Developmental Impacts of a High Palate
A high palate can present several functional challenges for an infant. Feeding is a common concern, as the altered palate shape can hinder a baby’s ability to create strong suction or a deep latch during breastfeeding or bottle feeding. This can lead to inefficient milk transfer, clicking sounds during feeds, nipple pain for the breastfeeding parent, and poor weight gain for the baby. Difficulty forming a proper seal can also cause a baby to swallow more air, resulting in increased gas or reflux.
A high palate can also affect a baby’s breathing patterns. The elevated palate reduces space within the nasal cavity, making nasal breathing more challenging, especially with congestion. This can lead to increased mouth breathing, which may contribute to noisy breathing, sleep disturbances, and sleep apnea. Persistent mouth breathing can further hinder the natural widening of the palate.
The palate’s shape can influence speech development. The tongue needs to make contact with different parts of the palate to form various sounds. A high arch can limit the tongue’s movement and its ability to achieve the necessary contact, making certain sounds difficult to pronounce. A narrow palate can also affect teeth alignment as they emerge, leading to crowded teeth or other orthodontic concerns later in childhood.
Therapeutic Strategies for High Palate
Addressing a high palate involves various non-invasive and therapeutic approaches. Specific feeding techniques can help infants experiencing difficulties. For breastfed babies, experimenting with different positions, such as the laid-back position or a modified football hold, can facilitate a deeper latch. This allows the nipple to reach further back, improving milk transfer and reducing discomfort. For bottle-fed infants, using bottles with larger or multi-hole nipples or specialized feeders can assist milk flow and intake. Paced bottle feeding, where the baby controls the flow, can also manage intake and reduce air swallowing.
Myofunctional therapy focuses on improving tongue mobility and resting posture. These exercises strengthen oral muscles and encourage the tongue to rest in the roof of the mouth, which naturally supports palate development. While direct palate expansion in infants is not typically achieved through exercises, consistent tongue placement can help encourage the palate to widen over time. For babies, gentle oral exercises might include encouraging the tongue to elevate and sweep the palate or to create suction against the roof of the mouth.
Osteopathic cranial sacral therapy is another approach. This gentle, hands-on therapy focuses on releasing tension in the head, face, and neck, which can contribute to oral restrictions and palate shape. While research on its direct impact on high palates is limited, practitioners suggest it can help improve overall oral function and reduce strain related to the palate. If an underlying tongue tie contributes to the high palate by restricting tongue movement, addressing it through a frenotomy (a minor surgical procedure) can significantly improve tongue function, indirectly aiding in palate development and oral motor skills.
Navigating Professional Support
Parents should seek professional guidance if their baby exhibits persistent feeding difficulties, noisy breathing, frequent congestion, or discomfort linked to a high palate. Early intervention can significantly manage challenges and promote optimal development. A pediatrician is often the first point of contact, assessing the infant’s overall health and providing initial guidance.
A multidisciplinary team of specialists can offer comprehensive support:
A lactation consultant (IBCLC) can provide tailored feeding strategies and assess for tongue ties.
A pediatric dentist or orthodontist can evaluate oral anatomy and discuss long-term dental implications.
An ear, nose, and throat (ENT) specialist may be consulted for breathing or nasal passage issues.
A speech-language pathologist or myofunctional therapist can provide exercises to improve oral motor skills, tongue function, and address speech development concerns.
This collaborative approach ensures a thorough assessment and a coordinated management plan for the baby’s specific needs.