Saw a baby with a cleft on the center of the soft palate only, no hard
palate or lip involvement.  Mom nursed older baby for 7 months, weaning due
to low supply from separation/not pumping.  Cleft was not discovered until
day 2 and by day 5 had lost 12 oz from birth weight.  Baby is being fed
exclusively expressed milk with Haberman.  Mom has long nipples, pliable
areola and, with help, was able to get the baby to suck and swallow.  We did
pre-feed and post-feed weights because I have not had much experience with
cleft palate babies and was not comfortable assessing intake any other way
with this child.  Baby drank 8-cc in 10 minutes feeding time and was
appearing tired so baby was given the rest of his feeding with the Haberman.

When I listened to this baby I heard what I thought to be a lot more
swallowing than was really done.  He also had a lot more of the long jaw
excursions than would have been expected for that small amount of milk
transfer in a baby w/o cleft.  My question is:  Is it common for a baby
w/cleft to sound and look like they are getting more than they are?

Linda Pohl, IBCLC
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Phoenix & Mesa, Arizona

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