Louise, My daughter Eliza was born with a submucous cleft palate with the classic triad of signs(bifid uvula, short, transparent soft palate and notching in the posterior portion of the hard palate)and was very symptomatic from birth(unable to suck, bilateral ear effusions and nasal regurgitation). We labored mightily for three months before she was able to be completely breastfed and what a source of joy this was for both of us! Last June , at 25 months she had her soft palate reconstructed because of speech problems. We consulted three cleft palate teams in NY, NJ and PA and found no support for breastfeeding. I honestly believe that many plastic surgeons have no experience with cleft babies who are breastfed and base their decisions on other premises. My surgeon recommended no breastfeeding for three weeks and full arm restraints during this time. My husband and I were horrified! I did not want to wean my daughter at such a needy time but also did not want to be blamed for ruining her plastic repair if she should have an adverse outcome. One very helpful reference was: Cohen,M., Marschall,M., &Schafer, M. (1992). "Immediate Unrestricted Feeding of Infants Following Cleft Lip and Palate Repair."The Journal of Craniofacial Surgery(3),no.1, P30-1. Dr Cohen found no instances of wound complications in those infants with unrestricted feedings. He is at the University of Illinois Division of Plastic Surgery and was very helpful when I called him. I believe that his series of babies is now up to 450-500 from the 80 that is reported in the study. I also contacted Barbara Wilson Clay IBCLC and Sarah Coulton Danner CPNP IBCLC for their sage advice and experience. My surgeon believed that since my daughter was an experienced nurser (with suction) that she might put greater tension on the suture line .I do believe that this is a legitimate concern with a soft palate repair. I compromised and decided to play it by ear. She was so uncomfortable and shocked from the surgery that she didn't want anything in her mouth up til 6 days postop. She went back to the breast at that time without problems ,although I noticed that her suction was weeker for a few weeks. I never used the restraints ----My husband and I just held her constantly and were vigilant about not allowing her to go near the incisions. She has done well since then. I would recommend more discussions with the surgeon. I supplied mine with Jon Ahrendsen's web pages about the advantages of bf, Paradise's study on cleft palate infants,breast milk and decreased otitis,and Cohen's study cited above. You need more details about the size of the defect,the type of repair and the amount of tension on the suture line. Good Luck! Roberta Cricco-Lizza RN MPH MS - ----------------------- Headers --------------------------------