Please read the excellent information in The Breastfeeding Answerbook or
review the case studies in The Breastfeeding Atlas (my own book) for insight
on how to manage and what to watch out for in infants with clefts whose
mothers are breastfeeding.  It isn't that these babies can't breastfeed at
all -- most are simply unable (at least at first) to do it well enough to
grow adequately and to protect a robust milk supply.  Clefts can very often
be part of syndromic clusters and there may be other issues that impact
feeding behavior beyond the cleft itself.  Even an uncomplicated and small
cleft of the palate creates great feeding difficulty.  Babies must be able
to seal the oral chamber in order to create negative pressure (suction.)
The hole in the palate creates a vacuum leak, and the baby cannot suck.
Over time, some become able to milk the breast (at least partially) using
compression only.  Protecting the intake of such babies is very difficult in
many cases.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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