Becky writes about a 3 mo old who has recently had cleft lip repair, but who
still has unrepaired cleft of palate.  She wants to know about getting baby
to breast.  In my opinion, it is the cleft of the palate which tends to pose
more difficulty for the baby than clefts of the lip.  The perforated palate
prevents baby from creating a vacuum inside the oral chamber, so seal and
suction are compromised.  Like sucking a straw with a large hole in it.  The
baby's problems managing mom's flat nipples are doubtless going to continue
in spite of repaired lip.  Baby only has to use gums to compress bottle teat
to get flow.  This is why the bottle works.  You might try coaxing baby to
breast with a nipple shield with fast flowing feeding tube device taped
under it to try to keep baby interested in trying.  But the best thing is
that the baby has been well, thanks to the human milk.  If this baby's
doctors do the cleft repair early, maybe the baby can be brought to breast.
I think I recall Chele Marmet telling me some years ago about a baby she
worked with who had cleft repair sometime after 12 mo. and was brought to
breast. I would keep trying, and certainly keep impressing upon parents that
the stress of pumping is nothing compared to the stress of caring for an
infant with the pain and distress of chronic glue ear.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html