Dear Denise P.

I have been following your case of the baby with a bubble palate and slow
weight gain
very closely.  I didn't respond immediately since I am so far behind on
reading lactnet.  I would like to continue to hear follow up on this case
and wanted to share a reference that I found on bubble palates.

I am wondering why there has not been more discussion of the bubble palate as
a cause
of the baby's poor suck and resulting poor milk transfer.  I have zilch
personal experience
with bubble palates, so I tried looking it up in all of my main references.
 To my surprise
it is only listed in one (see next paragraph), though high palate is referred
to in the LC
series on Inadequate weight gain.  Your comments indicate that you are aware
that a
bubble palate is possibly a cause for sore nipples, but  I can't tell if you
are linking the
baby's inability to maintain strong suction to this also.  Your use of the
p-syringe rather
than a suction based supplementer causes me to suspect you do.  Yet, I would
have
expected more focus on this possibility rather than on mother's ability to
produce milk in
light of how mother's supply and baby's weight gain has responded
appropriately to your
intervention.

Here is what I found in Chele Marmet, MA IBCLC & Ellen Shell, MA IBCLC,
Lactation
Forms:  A Guide to Lactation Consultant Charting (Encino, CA: Lactation
Institute,
Publishers, 1993 for chapter in reference) chapter 4, page 7.
        "Concave bubble:  A concavity in the hard palate, usually about 3/8" to
3/4"(1 to 2
cm) in diameter and 1/4" (1/2 cm) deep.  Because the bubble may not fill up
with
compressed breast tissue during breastfeeding, the lack of vacuum may be
somewhat
similar to those of a baby with a cleft palate......."

Does this sound like what could be going on?  Is the mother's breast small
and inelastic
making it harder for the breast to fill in the cavity?  I wonder if this will
affect this baby's
bottle-feeding ability?

Hope this helps.  I will be on lactnet nomail from Dec 23-27, so I will not
be able to
respond immediately to any comments you may have on this.  I will be getting
the back
log for those dates when I return (I can't stand to miss any :-)) so go ahead
and keep
writing to all of us here.

Natalie Shenk, BS IBCLC; Private Practice LC in Findlay, OH, USA who loves
when
other LCs share the details of their difficult cases!  THANKS Denise!