Anne wrote:

<< Diane, you commented that the baby is not opening wide enough for this
 mother's large nipples so she is pulling down on the baby's chin and
stuffing the
 nipple into the baby's mouth.  Pulling on a baby's chin to make the mouth
big enough may be part of the  problem.  If a baby is not rooting and therefore
opening wide on their own, they  are not looking or ready for suckling.  When
pulling the mouth open, the  muscles in the TMJ tighten.  This can then lead
to the baby clamping down on mom's  nipple.  >>

As Ann wrote, pulling on the baby's chin ( or baby's anything, really) does
not encourage a baby to be a real active participant in feeding. This seems to
be one of the main differences between bottlefeeding the standard way (
unpaced, without watching for readiness cues) and breastfeeding or paced
alternative/bottlefeeding. The baby who doesn't open, either because they haven't learned
yet, or because they have been force-taught that there is no need, is a
reactive feeder. They may or may not be able to eat well if someone does the
initiation work for them, stuffs something already flowing abnormally and fast in
their mouths,  but they cannot/do not initiate mouth-opening, latching, sucking
before let down, and then waiting for normal flow and nursing. I think gentle
cuing on a relaxed chin, just to give the baby the feel of a wide open mouth,
a deeper latch with more rewarding milk flow, etc, can help teach a baby what
their responsibilities and payoffs really are, but doing it for them
forcefully doesn't teach them anything and seems to promote continued reactive feeding
only.
Judy LeVan Fram, PT, IBCLC, Brooklyn, NY, USA, where it's 84 on the first day
of Fall...

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