I apologize if this has been discussed before. I worked with a mom today who
had just delivered a 6'13" term baby boy with a complete left side lip, hard
palate, and soft palate cleft. Unfortunately the defect was a surprise, so
there was a lot to do. We called the major hospital that we will be sending
them to for the plastic surgery and were told that breastfeeding might be a
problem with one of the interventions they have planned. Specifically, the
thing is called a Latham device, used for gradually easing the cleft gums
together. Models are made at 2 weeks and then the device is installed at 4
weeks. It is best to not have any upward pressure on the thing so the
feeling was that the tongue action of breastfeeding would do just
that....push on the Latham device.

Because of the dramatic extent of this little boy's cleft, it is extremely
difficult to form a seal, in order to nurse with an SNS. The primip mom is
12 hours post-Caesarian so she doesn't have a lot to pump yet. He started
with a Haberman feeder tonight and will have his first appointment with the
surgeon on Monday.

The Latham is a metal plate with adjustment features that allow gradual
tightening to bring the gum pieces together, meanwhile protecting the intact
palate from collapsing

Anybody have any comments about the Latham device? I don't want to mention
the name of the hospital in this forum but suffice it to say we're talking a
MAJOR hospital where they really do perform fantastic plastic surgery. It
would be very difficult to say no to this caliber of cleft repair. I will be
contacting the LC on staff there but in the mean time I would love to hear
from anyone with experience with the Latham device.

Thank you in advance.

Bonny Nothern, IBCLC

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