It's unusual that a baby with a cleft of the soft palate can breastfeed 
directly. I would want to know how much milk mom is pumping per 24 
hours, and how much the baby is taking. A little girl at 3 mos generally 
takes about 23-26 oz, according to Hartmann's research group.

If baby cannot make the Haberman work well, but mom is able to pump more 
milk, perhaps using the Pigeon nipple will be better for this baby. 
Pigeon is a Japanese brand, but they are readily accessible on the net. 
The nipple is soft on the lower (tongue side) half, and firmer on the 
palate side half, and yields a strong spray of milk with slight 
compression by the tongue. If the baby cannot make this work, perhaps 
she will fingerfeed with a syringe and tube, with mom pressing milk from 
the syringe in concert with the baby's sucking movements. This can also 
be done at breast to give baby the illusion of breastfeeding, it worked 
well for a little girl with a cleft soft palate in my practice.

Regular bottles don't often work well for babies with clefts, they 
require too much negative pressure, and a baby with a cleft can't 
generate any unless the nose is occluded!

Another issue to check is that the baby is not getting milk into her 
nasopharynx, if so, she might be so uncomfortable that she becomes 
unwilling to feed unless she is "starving". Some babies self limit 
intake due to pain from reflux or improper swallowing.
Catherine Watson Genna, IBCLC  NYC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html