All the paci's I have seen do fit tightly against baby's mouth, essentially
preventing the lips from flaring out.

Assuming that babies listened to LCs and took their advice, there is one I
would be more inclined to suggest. It's a 'toddler' size paci that looks
like a horizontal oval. It's at least as wide as it is long and looks like
it would fill baby's mouth without triggering the gag reflex. No, it
doesn't keep baby's jaw wide open like the breast does, but it would fill
the space horizontally, encourage the tongue to extend over the gum, and
avoid the 'straw-slurping' action.

I do use descriptions of situations like you do to illustrate this is a
stop-gap tool, not something to be used any time there is nothing else in
baby's mouth. I describe driving down the freeway with a screaming baby in
the car seat. It might help - maybe - until you can find a parking space
under a tree for shade to stop and nurse enroute home.

--- Phyllis Adamson, IBCLC
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