Interesting case I would like some insight on. I had a mom who delivered a healthy baby. She was a primip, and both preg and labor/delv were uneventful. This mom was from Mexico and what she knew of her family history was also unremarkable. The baby appeared to be suckling well at the breast according to mom and staff nurses. However mom developed engorgement and infant dehydration. Obviously milk transfer was not accruing. On oral exam revealed the oral structure was normal. Suck assessment revealed very poor oral tone. No tongue movement noted just and up and down movement of the lower jaw. Poor seal of lips and almost no neg. pressure. When bottle fed this infant lost a lot of the feeding due to the poor seal. It also had problems with its suck swallow coordination. We started mom pumping and using a Haberman feeder . We also started suck training and having mom wear the infant 4 to 5 hrs. Per day. We followed this mom for 2 weeks in our out pt. Clinic at which time the infant was able to successfully breastfeed with no need for ABM. We chalked this up to the weird but interesting group. This week I again had a mom also from Mexico and a primip. She also had a neg. history and a normal labor and delivery. Her infant also had a decrease urine out put. Oral axam also revealed same type of problems as the above infant. Has anybody seen anything like this before. Is it coincident that both moms are Hispanic. Any other ideas for increasing oral tone. Thanks for your help Toni Lietzinger Rn IBCLC *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html