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.  Observe this baby when rooting to see how wide open it gets it mouth.
I see this practice frequently at the hospital and believe it is from the way
nurses bottle feed babies.  I have rarely observe a nurse waiting for the
baby to root before putting the bottle in their mouth.  Then these same nurses
when helping a mother breastfeed a sleepy, reluctant baby, will practice the
same technique.  :-(
Ann Perry, RN IBCLC
Boston, MA

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