I would respectfully clarify that the lips play a role in breastfeeding, but
it is perhaps a role that can be compensated for rather more easily than
deficits in other areas. The lips help form a seal that facilitates creation
of suction.  Infants with clefts of the lip may profit from their mother
gathering up some breast tissue and plugging that gap in the lip (as is
pictured in the Breastfeeding Atlas.)  Some moms use a finger to do this,
and some moms have perfect breast tissue (rather loose) that just naturally
fills in such gaps.  I've seen a couple of moms with infants with clefts of
the lip who had taut breast tissue and the babies had some difficulty
creating a seal (to the point of us being able to hear air whistling)
through the cleft and the babies rapidly tiring as they couldn't achieve
sufficient suction to stay latched.

Years ago, Wheatherly-White (the Denver surgeon) published a study showing
that infants allowed to go to breast immed. after lip surgery had shorter
hospital stays and no greater incident of post-surgical problems than
control infants.  He speculated that crying and artificial teats were harder
on the sutures than was nursing on a nice soft breast.  Subsequently,
plastic surgeons such as Drs Magee and Denk (each  in solo practices in
Virginia in the US) have been doing early repairs of both lips and palates
and allow babies to go to breast immed.  Citations for Weatherly-White
should be in the archives.  Dr. Denk has presented at BSC Conferences and at
ILCA, and has a website.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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