When a baby is exclusively breastfed, it's usually just unpleasant for
milk to come out of the nose.  If the baby is getting artificial milk,
there could be severe irritation and infection from milk going into the
wrong places.  In some infants, the nasal regurgitation can be caused by
a poorly timed closure of the soft palate with the posterior pharyngeal
walls.  This is the usual cause of the very occasional nasal
regurgitation seen with a high supply and a very young baby.  Usually,
as infants grow and become more mature neurologically, these little
glitches no longer happen unless there is a neurological or anatomical
defect.

Whether babies need treatment or not is usually determined by the
severity of the soft palate dysfunction, the cause, and the associated
problems.  If there is no soft palate function, the child will be unable
to make the "popping" speech sounds such as p and b.  There is a
prosthesis called a "speech bubble" that is sometimes used by people
with this condition.  Generally soft palate closure becomes less
important during eating as children begin to sit upright and eat
solids.  A person with VPI might be unable to drink from a straw,  but
that's not a significant enough deficit to justify surgery.  Since all
of the structures involved in this problem are muscular, surgery does
not work all that well.  Moms generally do find ways to help their
babies compensate, perhaps with the help of a knowlegable LC.
- -

Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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