Hello, Lactnetters - This situation came up today and I've not dealt with or remember reading about it anywhere before. So, I'm asking for your thoughts/suggestions. Mom of 2 week old infant, who has been feeding/gaining well up until late last week, called me this morning. I had done a home visit about 2 - 3 days PP. Baby was jaundiced and VERY sleepy. At that time, we discussed the rubber nipple issue. Mom was receptive and seems dedicated to BF, (but ya never know?). Anyway, now she states that beginning last Friday she's having difficulty getting baby to latch-on properly. Says she sucks in lower lip, can hear air wooshing in during feed, nipples are becoming more sore by the day and feels like baby not getting enough. Also, experiencing some engorgement. After some investigating, she admitted she used a pacifier one day while taking baby to doctor in car and in office. Pediatrician recommended water feeds to continue to bring down the biliruben. Mom tried the water a couple times, baby sucked a couple times then spit out the nipple, became upset, so mom decided it wasn't worth fighting over with her. (Incidentally, when she reported this to the Dr., he said don't worry about giving her the water. Maybe the baby will teach this Dr. something!) Then when this "lip sucking/I'm afraid she's not getting enough" thing started she broke down and gave a 2 oz. bottle soy ABM twice. She said that the baby sucks on its lower lip when she's not at breast, in her sleep, etc....came out of the womb sucking its lower lip. We concluded that this is a behavior that needs working on, she may be VERY prone to nipple confusion and that NO rubber nipples should be used. Mom has already seen what ABM can do to her normal breastmilk stools. We talked about feeding in the football hold position to assist with proper latch, trying different positions with each feed or during feed, growth spurts and how to guage baby is getting enough. As for the "lip-sucking", mom states that she tries to pull the lip out after latch-on if she is sucking it in, but it's real hard to do. Baby usually gets upset and comes off. I suggested she keep trying to get a correct latch, no matter how many times it takes to get it right and once she gets it right, to leave her there till comes off on her own. Mom was taking her off if the sucking slowed down and baby was just hanging out. Now this one I just pulled out of the air...I told her right before latch-on to run her finger between baby's lower lip and gum a few times, making sure to roll the lip outward. Then to check it again after latch and during feeding. I don't know if this will work and I told mom so, making sure she lets me know how it goes. Has anyone had any experience with this before and/or have any suggestions? I'd really appreciate any help anyone can give. You can e-mail me privately, if you wish. TIA Melody Engberg, IBCLC, LLLLeader [log in to unmask] Methodist Alliance Health Services Memphis, TN Brad Engberg [log in to unmask]