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Subject:
From:
Kathleen Bruce <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 19 Jan 2001 20:27:24 -0500
Content-Type:
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From: Kimberly Anthony LLL Leader <[log in to unmask]>

I am working with a mother & baby with some real challenges. Baby has a
portion of soft palate missing

So, this is a cleft palate?


Mother came to a LLL meeting & made the comment that she wishes that
someone would tell her it is OK to bottlefeed - that everyone keeps telling
her that she should be able to do this.

Everyone who tells her that she SHOULD be able to breastfeed a baby with a
cleft palate, whoever they, are not that experienced. It is not all that
easy to do this, and certainly not the norm. Christa Herzog in Switzerland
has a lot of experience with this.


We are going to try with shield & SNS as LC reported baby could latch & get
some milk with shield early on. I hope that baby can at least draw fron
breast directly & eventually cut down on the pumping. LC said plate is a
good idea but not to introduce anyting new to baby now.

I have no personal experience using a plate, also known as an obturator,
because no one in my area makes them.

I have several questions for lactnuts out there:
1) Is the shield & SNS where to start? Pros & Cons?

Any attempt at breastfeeding can be tried. If there is no bf now, what is
there to lose?
I don't believe that a shield will help with a cleft of the soft palate
however.

2) When should the prosthetic be introduced? What are the pros & cons of
that?

I would ask Christa Herzog this question.

3) Any ideas on the mother's comment regarding bottlefeeding. I have been
doing lots of listening & reflective listening but it sounds as if she
still doesn't feel supported. My job is not to convince her to breastfeed
but to support her if she needs it. But I am not going to tell her she
should just give formula either.

I would listen to her reflectively, and support her in what works for
her...as we are not the ones who are pumping so often...and lacking sleep.

4)Mother is seeking support from other mothers doing this. Do we know
other moms who pump bottlefeed &/or have cleft babies at breast?

There is a list for mothers who only pump.  http://www.pumpingmoms.org/


  I put her in touch with another mother who breastfed 2 cleft children but
this mom
took away the hassle aspect of these challenges from that conversation vs.
the positive idea that she can eventually get the baby to the breast.

She may get the baby to breast, but the possibility of this will increase
if her supply remains plentiful. I saw a short clip that Christa made where
a cleft baby did much better in the clutch (football) hold...as this helped
the baby to get positioned correctly. The baby was down more, as I
remember...so that the breast was kind of hanging over the baby, if I
remember correctly...and for that particular baby, it worked. I don't know
if it is repeatable, but it did work for that baby.  Email me for Christa's
email.


5)Is there something we should be doing specifically to suck train with
Haberman?

I am not familiar with anything specifically. Maybe the Lactation Institute
could help with that?

I apologize for the length of this - there is even more to say about this
case. THANK YOU IN ADVANCE.
Kimberly Anthony LLL Leader

I hope this helps a bit.


Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html

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