Would be grateful for any advice or comments.  I have worked with a number
of oral anatomy issues and am stymied by an infant (normal weight,
full-term) with what seems to be an overly wide mouth.  This is not
macrostomia, but close. Nose looks unusual too - rather upturned with very
large nares.  Poor seal both breast and bottle.  Reluctant to gape.  Lips
seem to wobble around as if with a will of their own. At rest lips don't
line up - it's as if the mandible slides sideways slightly (no torticollis
and mandible is not tilted in general).  Baby is happiest puckering up into
nipple-only position.  Low negative pressure generated, it seems, thus can't
hold onto deep/wide latch.  Losing seal at corner of lips.  Palate (hard and
soft) normal.  Mom has breastfed successfully before.  This little one
failed to gain weight till given expressed milk.  

Help!
Joanna Koch, IBCLC

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