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When a newborn is brought home, various things swirl in the minds of the new parents. One of the crucial things that every parent worries about is whether the baby can breastfeed or take a bottle.

This worry is not unfounded. Affecting about an estimated 30% of the US populace, a high-arched palate or a high-vaulted palate can result in the baby not feeding well.

A high-arched palate does not mean that the child will have continued feeding problems or any speech issue. The following paragraphs define high-arched palate, symptoms and how to treat it.

What is a High-Arched Palate

A high-arched palate is a medical condition where the child’s palate is very high and narrow.

A congenital developmental feature, high-arched palate (or pseudo-cleft) is caused due to the improper fusing of the palatal shelves during the child’s developmental stage.

A high-arched palate might happen either in isolation or as a part of conditions such as:
  • Apert syndrome
  • Crouzon syndrome
  • Down syndrome
  • Incontinentia pigmenti
  • Marfan syndrome
  • Treacher Collins syndrome
In some instances, high-arched palate develops even after birth as a result of certain behaviors such as excessive or chronic thumb sucking or excessive pacifier use. Open-mouth breathing can also play a part, but it is very rare.

A baby’s tongue plays a vital role in developing proper oral anatomy. The tongue fills and maintains the palatal shape.

If the baby keeps the mouth open, then the tongue rests flat on the bottom of the mouth, and the palate continues to expand and become narrow.

Symptoms Of High-Arched Palate

One of the main symptoms of the high-arched palate is difficulties in feeding. Both bottle-feeding and breastfeeding rely on the baby’s ability to suction properly with the nipple.

Proper suctioning becomes very difficult, if not impossible, with the high-arched palate. As the child grows, the palate continues becoming higher and narrower, which results in a chain of symptoms.

Besides feeding difficulties, other symptoms include:

Difficulty in nasal breathing

The upper palate also functions as a nasal cavity floor. Expansion of the upper palate results in the nasal cavity shrinking. This causes the child to breathe with an open mouth which, in turn, leads to increased expansion of the upper palate.

Difficulty in clearing nasal congestion

Constricted nasal passages lead to increased congestion and swelling causing challenges in clearing the nasal congestion. This forces the child to breathe through the mouth and increases the chances of upper respiratory infection.

Increased sleeping difficulties

As the congenital condition progresses, the risk of sleep apnea developing in the child increases manifold. Many patients suffering from this problem start sleeping on their side to get more oxygen. Patients with high-arched palate also tend to snore a lot.

Bones harden and start changing

At the time of the birth, the bones of a baby are very soft. As they grow, these grow harder. As the bones harden, many midface structural facial changes start happening, including a downturned mouth and increase narrowing between the eyes.

Development of speech problems

Older children with high-arched palate might end up with speech issues (specifically consonants) and start to develop impediment for sounds that needs the tongue to touch the upper palate.

Increased risk of poor oral health

A high-arched palate could result in the baby having crowded molars and swollen gums as they age. This, in turn, could cause tooth decay in difficult-to-reach places, eventually leading to the child developing periodontal disease.

Diagnosis of High-Arched Palate

The determination of a high-arched palate is usually made visually. In many babies, the higher palate is very obvious.

Researchers have developed a measurement system for quantifying the diagnosis of a high-arched palate. Researchers considered several different measurements – palate shelf width, shelf length, arch angle, and arch height – for determining the mean of these features.

They were able to calculate that a high-arched palate has measurements that deviate from the above mean measurements. The development of this measurement has helped in eliminating guesstimating the condition. Using these measurements helps the doctors to arrive at a measurable diagnosis.

For new parents, a proper diagnosis besides providing relief also shows the way ahead in the treatment of high-arched palate.

Treatment Options for High-Arched Palate

Treating a high-arched palate is very tricky. If a baby has no associated symptoms or can suck or feed without difficulties, treatment is unnecessary. If the baby or child develops problems as a result of the high-arched palate, the following procedures can be useful.

Repositioning and Strengthening Tongue

A human tongue is vital in many oral functions like speech and swallowing. A broad and flat tongue results in problems with consonants formation, and a narrow palate.

Some basic exercises can strengthen the tongue and retrain it back to the original position. However, these should be done under medical supervision.

Palate expander

If symptoms associated with high-arched palate crops up during adolescence, then the orthodontist may recommend the use of a palate expander. A palate expander covers the upper palate. A key is inserted into it which helps in gradual opening of the upper palate.

Oral-Maxillofacial Surgery

If the treatments mentioned above fail in curing the high-arched palate and it starts causing problems with either speech or breathing, then the doctor will advise oral-maxillofacial surgery for expanding the upper palate arch.

This does not necessarily shrink the arch height but does open it up, creating space for the nasal passages. This might aid in relieving nasal congestion, making breathing easier. It can also help address sleep apnea.