Babies with a hyperactive gag reflex have a hard time tolerating the
nipple far enough in their mouths to facilitate a good suck.

One thing I would look at is the tongue attachment.  Baby might have one
of those sneaky tight frenula that is a little farther back than usual,
but still tight.  This leads to lack of tongue mobility and gnawing suck.

An asymmetric latch will help protect mom's nipple and allow the baby a
little more tongue contact with the breast.  Perhaps she will need to
take a feeding or two a day "off" and give baby expressed milk some
other way.  If baby resists a deeper latch, perhaps using a mini
haberman feeder a few times a day, then transitioning to the regular
haberman teat might help him tolerate stimuli to the palate.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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