Following Cathy and Pam's thread...
Saw a baby this past week that completely baffled me. Month old child,
being breastfed with nipple shield and supplemented with bottle fed mother
milk and formula because he was failing to thrive.

Mother 's reason to consult was that she wanted to wean off the shield
because she thought it was the reason for the ftt.

Baby"s oral assessment showed normal structures and a surprisingly marked
gag reflex,  which was activated by just placing my finger at the front of
the hard palate, almost right behind the alveolar ridge.

Mom had learned to put the bottle into his mouth sliding it on his tongue
so he did not gag.

What surprised me was that he did not gag with the nipple shield. He did
not suckle effectively either, he had a strange fibrilating-rolling
movement (can't describe it better) with no swallowing, but the latch was
surprisingly deep with no gag.

Without the shield he would place his open mouth on the nipple and do
nothing. He did not explore it with his tongue except once very
tentatively. Nothing we tried (and I  tried all the things Cathy describes
to the best of my ability) got him to latch.

Seeing all this, added to him being a breech baby born by c-section, I have
sent him to CST with the very best therapist I know. But I could not
interpret all these symptoms nor help this dyad on the latch issue.
Fortunately mom was happy with the support and the consultation since
everyone had been telling her baby was a great breastfeeder and to just
wean him off the formula. She was glad to confirm her gut feeling that
something was wrong.

Any wise ideas? There is so much to learn!!

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