Hi Mary,
        And lactnutters, A paralyzed vocal chord is one that is for no
apparent physical reason (no webs, no extra folds, no growths, a normal
looking fold) does not meet at center with the other chord during normal
use, speech, crying, breathing, etc. This is either nerve related or
structural, which cannot be determined with endoscope, only maybe with
surgery. IT's also so RARE that few doctors we dealt with even knew what it
could be nevermind what the implications were.
        My son was born with his left vocal chord immobilized and made only
the slightest raspy wheeze for a cry. This has improved with the years to a
now nearly normal 4 year old voice. He did NOT require surgery. In fact
surgery to release an immobilized chord is very dangerous as it compromises
the airway and there may not be  anything to fix anyway.
        The concern is about aspiration of fluids into the lungs bc the
vocal chords do not close completely to seal off the airway during
swallowing.  However we all on lactnet know that aspirating breastmilk is
better than aspirating formula... And the epiglottis should do some of the
sealing work anyway, making the vocal fold issue lesser. Another question is
related to the ability to cough up something that is on or near the chords
-- fluids or mucous. Can this baby cough?
        My son NEVER had any respiratory problems assoicated with his vocal
chords. NO stridors when breathing(wheezes, sounds, rattles, difficulty
getting air) and if he did aspirate milk it never bothered him. He does
occassionally have trouble if something gets stuck on top of the fold that
doesn't move well -- so he coughs and voila he's fine.
        This doc that wants to gavage feed bc he doesn't know what could be
is really, in my never humble opinion, erring way far away from reality.
This baby is nursing at the breast now, hasn't had a problem in how many
days of life? Baby hasn't had any cyonosis probs,  Mom's milk is in!
HOOOORAY (that's better than I did without pumping and all kinds of help) so
what's the deal? why go backward to gavage? baby is doing fine at the breast
so he's fine!!! IT AIN'T BROKE!  SO DON'T FIX IT!!!
        I've already suggested a consult with the ENT who saw my son, and to
question the doc as to why if the baby is doing fine at the breast he still
thinks they need to gavage? Does he understand the day to day ridiculous
hardship of doing that to the kid? to the parents? to the mom who would have
to pump? that they live so many mile away for rechecks of the gavage... what
about all the problems with that??????
        Thanks for the rant. I spent three years trying to get a straight
answer about my son's voice and no one ever had the nerve to say, "gee I
don't know, let me get a second opinion" -- finally we met a guy who was
wonderful and told it like it is.

good luck Mary,
Anne