I agree that this baby needs careful assessment for breathing issues as he may break off suction in order to breathe. If a baby is grunting at one month I would be concerned. 

Laryngomalacia or tracheomalacia usually results in stridor, which is the sound of air being forced through a narrow space.
Grunting would signify significant breathing effort.

I have noticed that tongue tie can result in very nasal sounding breathing during feeding. An ENT once told me that if the tongue's forward movement is restricted and the body of the tongue cannot move forward it means that all structures are pushed backward and therefore the airway, which is quite small in babies, may be slightly compromised in a baby with a tongue tie, therefore the noisy breathing. 

If this escalates to a grunt it will be important to establish that the airway is not compromised in other ways. 
I would be suprised to see grunting in a submucous cleft but there may be a combination of factors. If there is a submucous cleft baby may be getting frustrated that he is not getting enough milk and therefore comes off the breast frequently, how is the milk supply and weight gain. What does she mean by short uvula, if the uvula is unusual it may signify submucous cleft, but checking that the breathing is uncompromised will be the first priority.

Loraine Hamm
Speech Language Therapist/IBCLC
New Zealand

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