Thanks first of all to all the responses a couple of weeks ago about the baby who was very slow to gain weight. This is a follow on since we now seem to have identified the problem.

The baby is now 10 weeks old and slowly gaining still. The mother has tried everything we could think of with little effect - breast compression worked to a small degree as did going to bed for 48 hours. However, the weight gain was still low - on average he has gained 55 ounces a week.

The mother has just seen another lactation consultant who has the most experience here in Singapore (my saviour this women - the person who I refer all my clients to when I am completely stumped). She has taken a good look at the baby and identified the baby has a channel or grooved palate. It seems that he is unable to maintain an effective suck. This would certainly explain the way the baby feeds almost constantly at the breast after 10 weeks, is frustrated and seems to gain so little. It also explains why when he was offered bottles he would not feed from a normal shaped teat and has only been happy with a tiny teat that has a very large hole in it.

My question is - anyone with experience of a baby with a channel palate? The mother would like to continue breastfeeding at least in addition to formula feeds and is planning to express as much as possible. At present though the baby is not able to take enough from direct breastfeeding alone to maintain a healthy growth. Does anyone know if this problem resolves as the baby matures or does the use of the teat from a bottle just aggravate the problem? Also, have read about a palatal obturator being used for babies with cleft palate before surgery is done. Does any have experience of these and how successful they are likely to be. We don't have availability of banked breastmilk in Singapore so that is not an option. I have offered to relactate myself to provide expressed milk (I stopped feeding my daughter 2 years ago after feeding her for 3 years and had fed 2 other children so don't know how successful this would be if I pursued it - may be asking for advice on relactating in the next few days!)

Thanks again for the suggestions and assistance. This list is just the most wonderful resource.

Nikki Macfarlane
Singapore
Doula & Childbirth Educator
www.parentlink.org

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