Whenever I hear someone say that baby keeps a tight jaw, or clenches it, or the BF helper has to do something to get the baby to "relax" their mouth a little, I think of what I call "jaw clenchers." These are the babies who do not open wide, to a normally wide gape like a yawn. They latch on with fish lips, or pucker kiss looking lips. I only have two suggestions: try the technique on the videotape out of Australia called "Follow Me Mum" where the baby comes in lower than normal for the US under the areola. The nipple is kept up high near the nose and the baby instinctively tilts his head back, drops his tongue, and opens wide. Mom helps "flip" the nipple into the top of his mouth. More of the chin is smooshed into the breast than normally done in the US and the nose ends up tipped widely out. More areola tissue is in the mouth from the bottom lip than from the top lip. You can purchase this videotape from Caper's Bookstore (do a search for the name). 

I don't like to hear people say they pull the baby's jaw down, this can possibly be harmful to the baby. Sometimes doing so gently is helpful, but sometimes it makes them clench harder. 

The second suggestion is craniosacral therapy. I have seen this work wonders on tightly gaped babies. For really tight jawed babies, craniosacral therapy is the only thing I have really seen work. (And this particular practioner was very skilled.)

Hale says Demerol affects babies "neurobehaviorally." What I see with babies exposed to lots of demoral is poor sucking and rooting behavior, going to sleep quickly before doing any milk transfer, higher levels of weight loss, etc. 

Good luck, Kathy Eng, BSW, IBCLC

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