Louise,

> Mother has flat nipples.  After vigourous pumping, the nipple will
> protrude some, for a short duration.

She might also try the inverted syringe that we have been discussing, or
using a little ice on the nipples right before attempts.

>>But baby (6 days old) has refused the breast from the beginning and will
NOT bring his tongue forward.  Has been finger feeding from the start,
no artificial nipple, no pacifier. What can we do to convince him ? >>

Is there any possibility that this baby is tongue-tied? You didn't
mention whether she checked out the frenulum at all. Also, what kind of a
birth are we talking about? Was mom medicated, or was baby suctioned or
forced to breast the first time?

If the tongue is not mechanically limited, finger feeding with gentle
draws forward on the tongue in rhythm to the suck may help encourage it
forward. Positionally at the breast, any position that places baby above
the breast uses gravity to help encourage the tongue to drop down. Does
baby *never* bring the tongue forward, or is this a latch problem? I find
that stroking the lower lip only --downward-- helps babies to drop their
jaws and tongues when attempting a latch.

Strategy-wise, and ruling out mechanical problems, I would consider
nursing strike techniques, which include attempting to breastfeed baby
when alseep or half-asleep or drowsy. Anticipating hunger so that baby is
half-ways reasonable, or trying after a partial feed, may also help. I
have yet to try it, but the "rebirthing" in the bathtub technique sounds
very promising and is definitely worth a try.

Good luck to your friend!

-Lisa


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Lisa A. Marasco, IBCLC                                /  [log in to unmask]
International Board Certified Lactation Consultant    /  [log in to unmask]

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