Jennifer -
One of my resistant babies recently "caught on" when her mother began "thumb-feeding" - tube-feeding using her thumb because it was fatter than an index finger, and because it allowed her to have the baby facing her in much more of a breastfeeding position. She fed on one of those platform-type cushions, which allowed a bit looser hold (resulting in less resistance from baby). Mom's exposed nipple was right nearby.
Another thought is to use a different bottle/teat. The nipple on an Avent is longer than any real nipple I've seen, and it's really easy for babies to purse their lips on the stiff, skinny tip. No point in using much jaw motion; jaw excursions would mean a loss of suction, and it's not a very compressible nipple even if they try. What about an Evenflo Comfi, which has a very short nipple that's easily by-passed so baby lands on the very soft, wide base?
I learned from Cathy Genna that tongue-tied babies may have "naive" palates - palates that never learned to accept pressure from a mobile tongue. So maybe some suck-training with an eye toward desensitizing the palate?
And I learned from her that tongue-tied babies may have trouble controlling flow, and may behave like "oversupply babies" whether or not they really are. She observed a poor tongue-tied baby swallowing more than 70 times without pause, because he just couldn't get control.
I guess I'd start by thinking of this as a baby whose aversion is based on a sense of flooding, and who is reluctant to have breast or bottle touch his palate.
Diane Wiessinger, MS, IBCLC Ithaca, NY USA
www.wiessinger.baka.com
>>I was asked to consult by a colleague today on a 3 month old boy... While the mom managed to breastfeed exclusively through the pain for the first 10 weeks, she has been using bottles for the past 2 weeks to manage the pain. Now the baby is refusing the breast completely. Mom's latch is not asymetrical at all--baby is not tipped back, nor pulled in close to the chest, but attempts to correct this were refused by the baby.
Baby is being fed with an Avent #1. ... his jaw still has little mobility. He pulls his cheeks inward close to his mouth to hold the bottle nipple in his mouth, as his tongue does not cup the nipple. Even with the clipping, his tongue is short and remains flat, his palate is high, but broad. Upon observation, it is as if the baby has too much breast in the top of his mouth and not enough to work with his lower jaw. His use of the bottle is very passive, he swallows a lot of air and seems to struggle with its poisition in his mouth. He does not flange his lower lip or grasp the bottle very far past the nipple.
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