A good friend of mine has a newborn with a full cleft lip and palate.  Mom was
able to put baby to breast in the first weeks (while keeping supply up with
pumping) and although he did seem to be able to maintain a latch and suction,
that has since changed.  He is now five weeks old and is fully breastmilk fed
(thanks to a boost from Reglan when mom's supply started to dwindle from the
stress of it all) but his cleft palate has actually seemed to "widen" over the
weeks as he grows and he no longer maintains any suction on breast or bottle.
Mom has special bottles, which she recieved after contacting the Cleft Palate
Foundation <www.cleft.com>.  Bottle needs to be squeezed in order for the baby
to drink.  Right now, mom is not putting baby to breast for feeds at all,
since she can't get the milk flowing fast enough for him when he is hungry,
nor maintain milk flow  without any effective suckling.  I think that this
baby's cleft palate is particularly large, so that a baby with a less severe
cleft might have more success maintaining suction.  I thought to suggest mom
try nursing for comfort just to see if it *is* comforting to baby (pacifiers
are a big no-no for cleft palate babies, apparently) , or to try breast
compression (actually more like hand expressing into the baby's mouth while he
is "latched") if she thinks that will encourage him to eat more from the
breast.  What do you all think?  I don't want to overwhelm her ... feeding a
baby with a full cleft/palate is a very *time consuming* thing, plus of course
she is pumping and tending to her other child who is five years old.

Lisa Jones, LLLL in Wellington FL