I have had experience with infants with clefts being fitted with obturators.
They have some advantages, and also pose some problems.  There is an older
study (Markowitz J, Gerry R and Fleishner R:  Immediate Obturation of
Neonatoal Cleft Palates, The Mount Sinai J of Med 1979; 46(2):123-29.)  The
first two authors are dentists, and the person who has created obturators
for me is a pedodontist. The local cleft palate team here told one of the
mothers I referred to them for discusssion of obturators that they "Don't
believe in obturators here."  I almost got the feeling they were confusing
it with some other kind of appliance.  So I don't know if new research has
altered the opinion of cleft teams concerning the device, or perhaps this is
a case of "belief" system medicine preventing the filtering down into common
use of a new technique.

 One of the interesting findings of the study referenced above was that:
"All the babies showed maxillary growth in all dimensions, but within the
cleft area growth was more rapid.  By the fourth or fifth week [of obturator
use] all defects showed a minimum of twento to twenty-five percent filling
in with soft tissue in both superior and lateral aspects...Uniformly
positive results have demonstrated a pattern of easy acceptance by both
child and parent, and essentially normal feeding program, a decided
reduction in the size of the defect without diminution of maxillary growth,
an improvement in the cleft palate sound toward more normal speech, a
posititive reinforcement of the family structure, and ancillary benefits
toward the well-being of the child" pg 125-6.

My experiences have not been quite so dramatic, however they have been
mostly positive.  I have found that obturators work better when the cleft is
not just of the soft palate.  These seem to be less benefited by obturation,
and harder to fit.  Babies grow rapidly and new obturators have to be sized
over the months.  The cost is around $150-250 per appliance.

I would be quite interested in the experience of others who have used
obturators, and for information about more recent studies done looking at
the efficacy of this device.

Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html