Sorry, have been in Asia and now am sooo jetlagged. This is a primary 
symptom of velopharyngeal insufficiency, a condition where the baby does 
not close off the nasopharynx with the soft palate for either functional 
(timing, strength, tone) or structural (submucosal cleft, short 
hypoplastic soft palate) reasons. Upright positions can help, as can 
work on improving tongue grooving.

There's info in Supporting Sucking Skills, you can search for it in 
google books and read relevant parts of the first edition. Don't know if 
the second is up there yet.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

On 7/12/2012 3:14 AM, Phyllis Adamson IBCLC wrote:
> Possible soft palate cleft? Some can be easy to miss.
> Phyllis
>
> ---- Lesley Smythe <[log in to unmask]> wrote:
>
> =============
> Hi
>> I am working with a mum who is happy for me to post and ask for any thoughts about her situation.
>> This baby is the mums 2nd child and she breastfed her older child with few problems. This baby who is eight and a half weeks old and had a normal delivery is gaining weight well and thriving. Since birth he has always had milk dripping from the lower nostril whenever he nurses. The drip is steady and sufficient to wet the mums clothes and she has to resort to putting a cloth over herself to soak up the milk.
>>
>> The mum has also been experiencing very painful and damaged nipples which bleed during the feed and on occasions the blood has dripped out of the baby's nose which is very distressing for her.. Her nipples look pinched after the feed but no amount of careful positioning seems to help. He has been seen by a pediatrician and checked for a cleft in the palate and I suspect a tongue tie but am not experienced enough to know for sure as he seems to be able to extend his tongue over the gumline. I have made some adjustment to his position again but feel something else is going on.
>> Any words of wisdom would be much appreciated
>> Lesley LLL Leader
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> --
> Phyllis Adamson, BA, IBCLC, RLC
> Glendale, AZ.
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