YES, YES, YES, Diane. Thank you for describing this and making it 
clearer for myself.

I often hear loud gulping or swallowing sounds and the intake is 
pitiful. I had a baby like this on Friday myself. Preemie discharged 
from hospital and a slow/poor bottle feeder who also dribbles on the 
bottle. Breastfeeding looked really good, lots of sucking, eyes open, 
loud loud swallows but 6 ml intake at the breast. I suspect some kind of 
oral motor dysfunction or problems with these  loud swallowing sounds. 
Perhaps a weak tongue??

Also, when it is "just" overabundant milk supply or too fast MER, there 
are times of quiet swallowing after bouts of loud swallowing. With the 
problem babies, the loud swallowing is constant and even when there is 
little or no jaw movements.

Kathy Eng, BSW, IBCLC

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