I am working with 2 babies now who have a cleft of lip and palate. One
baby, whom I have been working with from birth is 4 weeks old and has been
at the breast since the beginning.  Sometimes mom uses the supplementer and
sometimes the Haberman feeder.  Baby sleeps with mom and is at the breast
almost all night.  Fourth baby, others breastfed.

I just began working with the second baby and mother.  Baby is 4 months old
and was at breast for 2 days, when mom was told to not bother because he
would not be able to feed at the breast. He is the 3rd baby and baby One
was fed for a few months and baby Two was fed for 14 months.

He had been feeding (human milk) with a feeder, which is squeezed by mom,
until his lip surgery 2 weeks ago, after which he was fed by a thin teat
that requires no sucking at all. The surgeon (who "owns" this baby's mouth,
and controls all that goes on with feeding, even to the hour and day, IMO)
has said that baby has no suck.  Mom tells me that he did have in the
beginning, but doc forbid any time at breast or any feeders that
necessitated suckling. He will not have his palate surgery until he is 9
months old.

I have worked with only a couple of babies with clefts, with limited
experience, so I don't know what skills the different ones do, in fact,
have. From my reading I see that there are wide variables.

This mom has called me to help her baby to breastfeed.  When the 2 weeks
after lip surgery was up and she was allowed to put baby to the breast he
didn't know what to do and he resisted being there.  So she has called me.
He seems to have some oral aversion, not surprisingly. Do you think that
this baby who has  "never suckled" for his milk will, at 4 months of age,
be able to retrieve that instinct--at breast or bottle?  Will bottle
feeding with Haberman or such be a good beginning for him?

Mom holds baby most of the day.  He sleeps better when she holds him, so
she does. I suggested skin to skin while she holds him. What do you think
about the rebirth bath?  If his palate is greatly effected are her efforts
in vain? I am mainly stressing patience, respect for baby, and "there is
plenty of time."

I want to be informative, and supportive of her deep desire to breastfeed
her baby, and I am one who believes "never say never," but this is rather
new territory for me, as the Milwaukee Cleft Clinic is reputed to be very
anti-breastfeeding. My focus would be to have baby comfort suckle at the
breast even if most of the milk intake is with bottle.  I do have several
stories of babies who resisted the breast for 3-4 months then latched on
fine, but these babies had not had surgery nor did they have incomplete
palates.

I have read all of the posts from Lactnet and Lactnet95-96 and they were
most helpful.  Anything else that you could tell me, either research or
anecdotal will be greatly appreciated.

I am meeting with this mom and baby for the first time on Tuesday of this
week. We have been communicating by phone this past week.

Thanks,

Patricia Gima, IBCLC
Milwaukee
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