I have recently completed  my course work to take the IBCLC exam this July, so I am not a IBCLC yet;  I am a nurse on a postpartum unit in California. I had a cleft palate baby this week, soft and partial hard palate; discovered when unable to achieve a seal at breast with my initial attempt supporting mom with nursing.The baby was 18 hours old when I assumed care. I would have liked to work further on this with this mother. However the pediatrician and consulted Speech Therapist informed mother that a cleft palate put this baby at greater risk for aspiration, and broke out a pigeon feeder with a cleft nipple. I remember from my course work that babies can breastfeed well with a cleft, if not to severe and baby is able to form seal with breast tissue. I don't recall babies with cleft palates being more at risk of aspiration with breastfeeding than bottle feeding. I am looking for evidence based research/ information on the risks of  breastfeeding vs
 bottle feeding  with cleft palates I can review, then use to have a conversation with these professionals. Anyone have any good references for me? Thanks, S Pack RN

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