I do not have an enormous experience with breastfeeding and cleft palate
babies.  However, as you all know, the problem with a baby with a cleft
palate is the difficulty getting him to latch on well.  The fact that
the cleft involves only the soft palate does not necessarily allow the
baby to latch on better.  In fact, it is my impression that these babies
latch on more poorly than some babies with a through and through cleft
palate and lip.  They will however, at least allow the breast into their
mouths.  If there are other factors which make a good latch more
difficult, then of course, the problem is compounded.

Still, it is possible with a cleft palate to breastfeed.  Without a
cleft palate, some babies with the most appalling latches manage to get
enough milk.  This happens because with an abundant milk supply, the
baby does not need a good latch to do well.

Thus, if the baby is latching on, encourage as good a latch as possible.
Use breast compression to help the baby get more milk.  If necessary,
supplement with cup or finger feeding.  The nursing supplementers do not
usually work, but it might be worth a try.  The mother may have to work
hard to build up a good supply.  Pumping after feedings, etc.

However, if it is not possible for the baby to breastfeed, it is still
possible for the baby to get breastmilk some other way, which is second
best. (Artificial baby milk is not second best).  The baby may also be
comforted at the breast even if he does not drink.  And if the baby
accepts the breast, even only for comfort, the baby may actually start
breastfeeding when the cleft is repaired.

So encourage the mother.  Take the long view.  Less than perfect babies
need breastmilk more, not less.  Let her know it is worth it even from
the point of view of preventing some of the ear infections babies with
cleft palates get.

Jack Newman MD, FRCPC