Someone (sorry I just read a bunch of Lactnet posts and don't remember)  
asked if wouldn't the baby's physician have seen if a cleft was present on  
examination of the newborn.  
 
I happened to be the one to find a cleft of the soft palate in a baby who  
was a little over two days old and was reported to making funny noises and  not 
staying on the breast. I decided to do a digital exam on the baby.  I  had 
looked in the baby's mouth, but not with a tongue depressor and a  light.  I 
planned to look at it later since I didn't have my penlight with  me in the room.  
 When I slid my finger back toward the soft palate I felt  a notch - a small 
'V' at the back of the hard palate and then my finger dipped  slightly into a 
defect.  With the gloves on I could not tell if it was  submucosal or not.  So 
I left the room, asked the nurse to call the  Dr.  
 
 
I meanwhile had gone on to another patient who needed to see me.  When  I 
came out the midwife had just arrived to see the mother so she  checked without a 
glove and then looked and saw the soft palate  cleft.  You could not see it 
by just looking unless the baby was yawning.  and he just missed it. 
 
This baby appeared to make a good seal with the lips, but obviously could  
not create suction within the oral cavity.  So I had the  parents call her 
baby's doc to tell him what we'd found.
 
Mardrey Swenson IBCLC 
 
 

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