One of the first problems a baby with cleft palate might have is difficulty breathing or eating. Cleft palate usually makes breastfeeding difficult because the infant has difficulty sucking properly. The palate prevents food and liquid from going up the nose when swallowing. To prevent liquid from passing into the nose of a newborn baby with a cleft palate, a bottle with a special nipple may be used to feed the baby breast milk or formula. Kids born with cleft palate may also have frequent ear infections. That’s because air and fluid can’t pass normally through the Eustachian tubes, the tubes that connect the throat with the middle ear. This means fluid and germs can become trapped behind the eardrums and cause infection. Some people with cleft palate may have had an operation to put tubes in their ears to help the fluid drain properly. In some cases, people who have cleft palates may have hearing loss because of repeated infections and fluid behind the eardrums. Dental problems, such as cavities and missing or malformed teeth, also are common in people born with cleft lip and palate. Speaking clearly can be challenging for kids with a cleft palate. Sometimes the soft palate doesn’t move well enough to prevent air from leaking out through the nose during speech. This can cause their voices to sound as if they are speaking through their nose. If the teeth don’t line up properly, a person may not be able to pronounce certain sounds. In most children with clefts there are no other physical or learning problems. For some people, cleft palate and cleft lip may be associated with other birth defects, such as heart defects, or other physical problems, such as growth disorders and muscle weakness and some learning difficulty.