Radionuclide scans in reflux nephropathy

Early feeding difficulties in infants with a cleft palate are well documented' as is poor mother-infant bonding.2 For many years these infants have been fed with various makeshift modifications of a teat. Over the last year we have been using a new feeder specifically designed to overcome many of the problems of feeding such infants. The new 'Haberman' feeder consists of four components (see figure). The flanged cylinder (solid, food grade silicone) has one end formed to accept a mushroom valve through which the milk enters the teat; this provides a non-return passage for milk from a conventional feeding bottle. A lateral channel is incorporated in the posterior aspect of the flange to allow air to enter the bottle, preventing a vacuum being formed in it. The teat is made from tear resistant food grade silicone. It is soft, malleable, and transparent and fits over the cylinder to form a liquid and airtight seal. The mouthpiece has a slit valve opening with markings on the teat body to indicate the position of the slit opening relative to the infant's mouth; this controls the flow of milk to the infant's mouth. Sucking by the infant compresses the teat alone so that it is not wasted on compressing air inside the bottle. The feeder is attached to the bottle by a collar. We have recently used the new feeder with six infants: two had bilateral clefts and the remaining four had unilateral clefts. Their gestational ages ranged from 36 to 42 weeks with a mean weight of 2-8 kg (range 1-9 kg-3-2 kg). Three infants were initially fed with conventional teats while the remaining three used the Haberman feeder from birth. It was found that the infants fed faster and more