Happy New Year to all!

I seek your collective wisdom and expertise on the anti-bacterial and
immunological properties of breastmilk.  I am working with a 3-week old baby
who has a narrow unilateral cleft of the soft and hard palates (extending to
approx. midline of the hard palate).  The anterior palate and upper gum
ridge are absolutely normal.  She was fitted with a "plate" (obturator?)
which covers the palate and upper gum ridge, which is secured in place with
pink glue. She is being finger-fed exclusively her own mother's milk.  She
can latch to the breast and suck without the plate in place, but the parents
have been advised that she must wear the plate at all times.  Latching to
the breast with the plate in place is proving extremely difficult because of
the prominent upper gum which prevents lip closure and the reduced depth of
the palate.  The parents have also attempted bottle-feeding EBM, but the
baby obtains more milk in a faster time (and prefers) finger-feeding.

Yesterday the parents requested a follow-up and weight check.  We were
dismayed to see that the baby had only gained 130g (4 oz) in the past 15
days and has not yet quite regained her birthweight.  They have been keeping
a careful record of feeding times and amounts, which show that the baby has
been receiving less than she needs - she will take a moderate amount, fall
asleep and then a short time later indicates a need for a little more (just
like a baby fed direct at the breast, yes?)  However, the parents have been
advised that they must clean and replace the plate after every feeding, and
consequently they have been reluctant to feed her more milk after this, even
if she indicates a need for more by rooting/crying because then the plate
will have to be cleaned and replaced all over again!

I can understand that if the "milk" being used was ABM then there would be a
risk of infection, but my question to you is: Does this risk still apply if
the milk is breastmilk, which could be expected to inhibit the growth of
pathogenic bacteria, reduce the risk of infection, etc?  Parents are
receiving advice from many different sources and if you have any
information/guidelines for me (and perhaps references?), or if you have any
other comments on the risk/benefits of breastfeeding-without-plate or
lack-of-breastfeeding-with-plate I would be so grateful!

Pamela, Zimbabwe (where is't raining and raining, the world's turned green!)