One possible way to help this infant is with positioning. Feeding in a 
more prone position might help her swallow more comfortably, reducing 
her post feed reflux. Breast massage right before feeding might also 
help. If she truly has a submucosal cleft, she's probably not great at 
sealing her nasopharynx . If this is so, you'll hear her breathing get 
more harsh and wet as she feeds. I've found that some babies 'drain' 
better if we lay them prone across mom's lap after feeding. It's also 
possible mom has a really large milk production and therefore a strong 
MER that causes the baby to get a LOT of milk at a feeding. Has anyone 
done a weighted feed?

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

On 10/18/2018 12:56 PM, Sharon Curtin-Bottomley wrote:
> I have reviewed the archives on this subject, but not much is available. Does anyone have experience with a submucosal soft palate cleft in a newborn?  I have seen a  2 week old who is feeding and growing adequately due to Mom's good supply, but from day 5 or so has frequent nasal regurgitation, several times daily of a significant volume that occurs soon after feeding while burping and 30 or more minutes after (small oozing). She shows no signs of distress with any of it. We are doing upright positioning and burping frequently. Parents had gone to peds in first week with this concern. I am told MD looked with penlight but felt all was wnl. I did gentle digital exam and looked using a penlight, but baby was very sleepy and not interested in sucking on my finger to evaluate suck, tongue movement. Nothing appears out of the norm. No bifid uvula, has great tongue lift and extension. She will see peds again and request ENT referral.  I realize this doesn't always need treatment, but curious if there are any who have seen the progression of how this can affect the newborn. I am aware that this often is missed until there are speech issues or chronic ear infections. If no treatment, what other ways can we prevent these problems? Thanks for your input, Sharon Curtin-Bottomley RN, IBCLC
>
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