I agree fully with Joy about the impact of a cleft of the soft palate on
bf efficiency.  Even an occult submucous cleft (a tiny interruption in
the musculature of the soft palate, without a bifid uvula) decreases
effectiveness of breastfeeding substantially.  It's one of the things to
look for when a baby can't maintain negative pressure...
Catherine Watson Genna, BS, IBCLC

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