Wolf and Glass (in Feeding and Swallowing Disorders in Infancy) describe the
immature response to fluids in the airways as apnea, followed by attempts to
swallow to clear the fluids.  There may or may not be a cough.  If the baby
is gaining well and is otherwise robust, managing for over-active letdown is
a good idea, and may be all you have to do.  Mom should observe to see if
these apnea episodes occur during letdown, or if they occur when baby begins
the feed, in the middle, or at the end (when fatigued). The timing of WHEN a
problem occurs during a feed can often give information about the cause.
If mom can get an ENT evaluation, it couldn't hurt, but I doubt you can do
anything about the unusual palate shape unless it is connected with a
submucosal cleft.


Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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