Dear wise ones,

A little while ago we had a brief discussion of bf a child with a cleft of
the lip/palate. Catherine Watson Genna gave us her wonderfull description of
how drinking at the breast works and doesn't work  and why and June Rychlik
shared her observations of the very determined mother of the child with the
very severe cleft.
I am in the process of revising an information text on bf and cleft. The
information has helpt me a lot to get a clear view on the subject and to
reformulate some of the information.
Both Catherine and June mentioned milk flowing into the airways and/or other
cavities (not doing real harm, but annoying and perhaps interfering with free
breathing) and June raised the possibility of using an SNS (at breast feeding
device).
This made me rethink a possibility that has occurred to me before and I would
like to hear some opinions on: wouldn't it be an option to place the tube of
the SNS underneath the breast instead of at the top as usual? In that way the
milk would directly be moved into the groove of the tongue from where the
bolus of milk can be swallowed.  The bottle could then hang high enough to
let the milk flow without any negative or positive pressure.
What do you all think? Am I way off reality or might it work?
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gonneke van Veldhuizen, IBCLC
MOM, LLLL, primary schoolteacher
Hiilensberg, Germany

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