Optimal nutrition, body weight, and health before conception, during pregnancy, and after delivery is the goal for all pregnancies. Obesity increases the chance of hypertension, diabetes, preeclampsia, prolonged delivery and fetal complications. Foods rich in calcium, phosphorus and vitamin D are important nutrients for fetal tooth formation in utero. Tooth development begins as early as the sixth week after conception and calcification of primary teeth begins at 4 months in utero. The most vulnerable periods of fetal development are indicated in the red bars below, where major defects, such as cleft lip and palate appear. Damage to oral structures are most likely to occur between 5 and 8 weeks gestation.16

Figure 10. Vulnerable Periods of Fetal Development.16
Figure 10 shows images of fetal development as well as timelines of development and vulnerability

Dietary recommendations before conception include taking a prenatal vitamin and incorporating folic acid rich foods in the diet to prevent neutral tube defects such as spina bifida, malformation of the brain and skull, anencephaly, and encephalocele.

Foods rich in folate include;

Chart listing foods rich in folate

Cleft lip, cleft palate, and cleft lip & palate (CL, CP, CLP) are common congenital birth defects, affecting 1 in 600 births in the U.S. Cleft lip and palate may be unilateral (one side) or bilateral (both sides). Because the lips and palate develop at different times during pregnancy, it is possible to have a CL, CP, or both CL/CP. Genetic factors, exposure to medications and alcohol are known to play a role in the development of CL/CP. Dietary considerations include acquiring adequate protein, folic acid, and B12 during pregnancy.21

Figure 11. Infant Cleft Palate.17
Figure 11 shows illustrations of frontal and cross sections of unilateral and bilateral cleft lip in infants

Feeding an infant with cleft lip/palate can be challenging. The main priority is to ensure adequate nutrient intake. The absence of negative pressure needed for sucking can make this difficult for new parents. Feeding in an upright position, frequent burping, limit feeding to 30 minutes every 3 to 4 hours and using special feeding bottles and nipples can enable the infant to feed more efficiently.22