Kathy
I would invoke the 3 main rules (adapted from Coach Smith, of course) that I
am sure you are using as well. 1. Feed the baby - I would use whatever
method seems "easiest" on the baby. Be it bottlefeeding, fingerfeeding, or
other. Barbara Wilson-Clay tells alot about stress cues, and resp.
compromise etc. Her posts are very beneficial to read. 2. Protect the milk
supply - regular and efficient milk removal. 3. Fix the breastfeeding - this
is getting mother and baby directly bf together. This can take awhile. This
is where "suck training" or "suck exercises" whatever it's called can come
in. For example, if tongue is on roof of mouth, some finger feeding or
finger sucking could be done or even using a pacifier. Or cup or spoon
feeding could be done a bit to get baby to extend tongue. Do alot of
kangaroo care too. Try different positions, as baby may do better flexed in
certain ways, supported in certain ways, or do well sidelying. At some point
the  rebirthing baths could be done too. I would let the parents know that
this may take time, don't expect too much too soon. Due to the vacuum
extraction, and epidural there may be some effects and due to the baby's
possible anomalies, there could be some effects. The baby may be helped by a
CST, or chiropractor, and the mother could be referred to a bf support
group.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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