Why Feeding Fails, and What Helps Right Now
Why can't Mateo feed normally, and what can we change today to help him before any surgery?
💡 Mateo's feeding problem is a missing wall, not weak muscles; we feed around it until surgery rebuilds it.
Prerequisite check
- A involves one side; a cleft involves both, leaving a central segment standing forward and a short .
- A runs through the full structure; an incomplete lip spares a bridge of skin called a .
What you will learn
Goal: Explain why an open prevents an infant from generating suction, and recommend feeding interventions that compensate, using Mateo's .
- Normal feeding needs : a partial vacuum made by sealing the mouth and lowering the pressure inside it.
- Building that vacuum requires a closed chamber, and the roof of the mouth is the wall that seals the mouth off from the nose.
- Mateo's makes mouth and nose one space, so he cannot hold a vacuum and suction feeding fails.
- Before surgery the fix is to bypass suction: a and , with careful weight tracking.
Model: Two infants, one feed
A typical newborn feeds by sealing the lips around the nipple, raising the tongue, and closing off the back of the mouth with the soft . This sealed chamber lets the baby drop the pressure inside the mouth below the pressure outside, a partial vacuum, and milk is pulled in. The intact roof of the mouth is the wall that separates mouth from nose, so the vacuum holds.
Mateo's roof of the mouth is not continuous. The normally forms when the palatal shelves grow, elevate, and fuse to wall off the oral from the nasal cavity. In Mateo that wall has a gap, so the mouth and nose are one connected space. Over his first feeds: milk escapes from the left nostril during sucking, he swallows a lot of air and stops often, and a feed that should take 20 minutes takes 40 while he still loses a little weight in the first days.
A parallel clue from the literature: in a study of 53 infants with , most did not have middle-ear fluid at birth but developed it within days to weeks, and 90.6 percent had middle-ear effusion at first exam. The same open connection between nose, mouth, and the tube to the changes how fluids move through the head from the first week.
Explore (work the model before reading on)
- In the typical newborn, what physical wall makes the sealed feeding chamber possible?
- In Mateo, where does the milk go that should have stayed in his mouth?
- Why does an open connection between mouth and nose make it hard to build a vacuum, even if Mateo's lips and tongue work fine?
- Mateo swallows a lot of air and tires quickly. Connect these two observations to the missing seal.
- You cannot rebuild his today. Name two things you could change about HOW he is fed that would get milk into him without needing a vacuum.
Guided notes
Why suction fails
- The wall that seals the feeding chamber off from the nose is the ____ (roof of the mouth).
- Mateo has an , so mouth and nose are one space and suction feeding ____.
The interventions
- A ____ bottle delivers milk by gentle caregiver squeezing, so flow does not depend on the baby's suction.
- ____ positioning (more vertical) lets gravity carry milk down and away from the nose, lowering nasal escape and airway risk.
The reframe
- Mateo's problem is not weak muscles; it is a ____ wall, so we feed around it until surgery rebuilds it.
Reading the Research
- Skim the title and abstract first to get the gist.
- Circle the one sentence that states the main claim.
- Box the evidence the authors give for that claim.
- Mark one sentence that confuses you, and move on.
Using the database (what to capture)
Part of today's expected outcome is to actually open the tool below and write down the value it gives you. That captured value is the evidence you will use in your Claim, Evidence, Reasoning. Follow the steps, use the labeled screenshot so you do not get lost, and record each field.
Plain-language explanations of a gene or condition, written for patients and families.
- 1Open medlineplus.gov/genetics and search the gene or condition (IRF6).
- 2Read the summary written in everyday words.
- 3Note the conditions the gene is linked to at the bottom of the page.
- Topic: IRF6 gene
- Plain-language summary: IRF6 helps the tissues of the face join correctly before birth.
- Linked conditions: Van der Woude syndrome; nonsyndromic cleft
Vocabulary (the same words your classes use)
Track your progress today
Check these off as you work through the lesson, then submit. This tells Mr. Mendoza how you're doing so he can help the class. It does not replace turning in your producible.
Use the code Mr. Mendoza gave you, not your name. Saved on this device.
- Read the Model and answered the Explore questions.
- Filled in the guided notes in my own words.
- Defined the new vocabulary with an example.
- Opened MedlinePlus and recorded the value it gave me.
- Built the producible: Write Mateo's one-page feeding plan for his parents: (1) one sentence naming the anatomical reason in plain language, (2) the bottle type you recommend and why it removes the need for suction, (3) the position you recommend and the two problems it reduces, and (4) the single number you will watch each week to know the plan is working. Keep it warm.
- Wrote my Claim, Evidence, and Reasoning exit ticket.
Exit ticket (Claim, Evidence, Reasoning)
- Claim: Mateo cannot feed by suction because of one specific anatomical fact.
- Evidence: Cite what the normally does and what is different in Mateo.
- Reasoning: Explain why a solves the problem even though it does nothing to the itself.
| Criterion | Proficient | Developing | Beginning |
|---|---|---|---|
| Complete | Every required part of the artifact is present and filled in. | Most parts are present, but one is missing or left blank. | Several parts are missing. |
| Accurate | The science and data are correct and match the evidence. | Mostly correct, with a small factual slip. | Key science or data is wrong. |
| Scientific reasoning (CER) | States a claim, backs it with specific evidence, and explains the reasoning. | Has a claim and evidence, but the reasoning is thin or missing. | Gives an answer with no evidence or reasoning. |
| Professional communication | Clear, organized, and labeled the way a clinician or scientist would write it. | Readable but disorganized or missing labels. | Hard to follow. |
| Submitted | Turned in the right way (Schoology for routine work) and confirmed. | Turned in, but in the wrong place or unconfirmed. | Not turned in. |
- CompleteProficient: Nothing is left blank: the model fills every part of "Write Mateo's one-page feeding plan for his parents: (1) one sentence naming the anatomical reason in plain language, (2) the bottle type you recommend and why it removes the need for suction, (3) the position you recommend and the two problems it reduces, and (4) the single number you will watch each week to know the plan is working. Keep it warm.".
- AccurateProficient: Every number and claim matches the case evidence.
- Scientific reasoning (CER)Proficient: It names a claim, cites the specific evidence, and explains the reasoning, not just the answer.
- Professional communicationProficient: It is organized and labeled like a real chart note.
- SubmittedProficient: It would be turned in on Schoology and confirmed.
Where this leads: careers
What's next: We can keep Mateo fed today by working around the gap. But the gap is wide, and the wider it is, the harder the lip repair will be. Could we gently shape and narrow the before any operation so feeding gets easier and the surgery starts from a better position? We chase that next time.