----- Original Message -----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Sent: Monday, November 17, 2003 7:11 AM
Subject: LACTNET Digest - 16 Nov 2003 to 17 Nov 2003 - Special
issue(#2003-1591)

In response to Jessica's post on an undiagnosed cleft. I too just recentlly
saw a baby with an undiagnosed cleft of the soft palate. It was bilateral.
This baby was unable to transfer any milk at the breast despite a mother
with a supply. She also took 1 1/2 hours to transfer 2 oz from a bottle and
was losing weight. When a baby does not create suction of any kind, it is
time to really view the oral cavity. This was missed in the hospital AND ped
office. We used a haberman with terific results. The baby is completly
breastmilk fed by haberman and will have surgery as soon as possible. To
answer your question, I have seen a number of babies wtith clefts of the
soft palate and they usually have difficulty transferring milk. It often
takes great effort on their part because they do not create suction. Try
drinking liquid with a stray that has a hole in it. You may get fluid up the
straw but you will have to work hard. Some of these babies get half the milk
in twice the time it usually takes for a feed. They get exhaused and may
limit their feeds. But their are differences in babies energy levels, extent
of the cleft, milk ejection of mother etc that can make for variables. It is
unfair to tell a mother that a cleft will make no difference, because she
will then think that it is she who is doing something wrong. When a baby
cannot transfer milk at the breast because of problems with the oral
structure than finding a way to get the breastmilk in is what is important.
Some of these babies can be fed by haberman or other bottles and get sucking
comfort at the breast. Be creative but make sure that baby gets fed. Ann
Anderson, RN,IBCLC NJ

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