There are a few tricks:
You can shine a light in the baby's nose (a penlight or otoscope) and 
look in his mouth. A submucosal cleft will show up as a thin area that 
lets more light through than the rest of the palate area does.
You can make the baby gag with a cotton swab to the soft palate, and 
look at the junction of the hard and soft palate (I prefer photographing 
it, then I can look at it as long as I want without torturing the poor 
baby!). It should be smooth and rounded. If it's notched or irregular, 
that's a sign that there might be a cleft.

Other things that increase the index of suspicion are bony bulges at 
either side of the nose (paranasal bulges), eyes farther apart than 
usual (hypertelorism) and a deeply indented upper lip. (I believe there 
are pics of these features in Supporting Sucking Skills, you can look at 
it on Google books if you don't have a copy).

If you see some or all of these things, especially if  the baby is 
having feeding difficulty, you could refer to an ENT (otolaryngologist) 
for a diagnosis. Submucosal clefts are frequently missed.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 6/17/2011 7:44 PM, Sonya Shaver wrote:
> How do you recognize a submucosal cleft palate?  I was wondering about that
> recently with a baby.
>
> Thanks,
> Sonya
>
>
> On Fri, Jun 17, 2011 at 4:45 PM, Katherine Koch<[log in to unmask]>wrote:
>
>>> I'm thinking 'high' isn't necessarily nice in infancy - is that
>>> something 'good' with the age group she is familiar with?
>> No, not in my experience as a school-based SLP (many years ago) and current
>> Special Education teacher working with many, many children with speech
>> disorders.  At the elementary level, I ask about oral structure if
>> appropriate, primarily to inquire about potential submucosal cleft palates.
>>   Palatal height is not usually an issue in the students I see, even those
>> who are unintelligible speakers.
>>
>> Kathy
>>
>>
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