Posting this for Catherine Watson Genna:

"Missing uvula is a big tip-off that the muscle arrangement that allows the
soft palate to function is abnormal. If you can get a good look, sometimes
you can see a zona pellucida (clear spot) where the soft and hard palate
meet. There is also sometimes a notch. The baby may also have a paranasal
bulge (a piece of bone that seems to be more prominent on either side of the
nose, and seems to run laterally).

Does this baby have nasal regurgitation during feeding (does milk come out
of his nose during or after feedings or during vomiting?) While normal
babies sometimes mistime their soft palate elevation and get milk in their
nasopharynx, babies with submucous clefting are likely to do it more often,
or at least to sound and be nasally congested as the feed progresses.

One good reference is

Stal S, Hicks MJ. Classic and Occult Submucous Cleft Palates: A
Histopathologic Analysis.* *Cleft Palate-Craniofacial Journal, July 1998,
35(4):351-358.

It is available on open access (free for the downloading at the journal's
publisher site). Just google or pubmed it.
Catherine Watson Genna, IBCLC NYC"

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