The archives have lots of reference to discussions we have had on this list
about infants with clefts.  These infants may have extreme difficulty
creating suction.  Some can do only a little breastfeeding, and some can
nurse partially (tho mother needs to pump post-feed to insure really good
breast drainage and continuing good supply.) I know there are reports of
totally breastfed infants with clefts, but I have never personally seen one.
My guess is that all through history, the ones unable to feed died.  In many
cirucumstances, the best case scenario is to keep the infant drinking
mother's milk however you can get it down them, and urge, of course, the
mother to cont. to put baby to breast for comfort, stimulation of breasts, etc.

I want to update the list on a lovely baby girl with a cleft I have recently
worked with.  Mom called me with a precipitous drop in production.  She was
using a Classic pump she had obtained elsewhere.  The milk supply was so
abuptly reduced that I suspected an equipment failure.  Turned out to be wet
filters which was an issue she knew nothing about.  I talked her thru that,
and arranged to get her spares so it won't happen again leaving her
stranded.  Due to equip. failure she needed to feed 6oz then 8 oz next day
of formula.  Baby has not had formula before.  Baby is 6 weeks and has had
NO RESPIRATORY infections!!  That is really unusual.  Most of these babies
don't get good support to make sure they get exclusive bfeeds in early days,
and by the time I see them, most have had lots of formula and by 1 month
most have already been ill.  I asked mom to call me if baby gets a
respiratory infection as a result of the formula exposure.  She has had more
nasal regurgitation in the days since formula, so I am crossing my fingers.
She is doing really well with Haberman feeder.  Mom tries to put her to
breast, but baby doesn't do much real sucking.  I am gently urging her to
try more.  Baby is growing great!!! MD really pleased with weight. This was
the baby (just to update newcomers) who got good support from hospt. LCs,
MD, Neonatologist about breastfeeding, and got a referral to me on Day 2 or
3.  So there was never the usual devastation of the milk supply to have to
recover from, with resultant formula exposure.

Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html