You don't say what baby's weight is now, but presumably if it is close to or eual to birthweight, she is getting the milk, regardless of what the nipple looks like.  If you are having to pry her off, it suggests she has got some kind of latch...

Two things to encourage larger mouth - 

1.  letting her suck on other people's progressively fatter fingers, like getting her to suck a grown-up's thumb.

2.  sitting her upright facing the breast for feeds helps drop the jaw and extend the tongue (is this dancer position)?

Is this a case where a nipple shield might help?  

Love, Chanita


----------
From:   Pearl Shifer[SMTP:[log in to unmask]]
Sent:   Wednesday, September 03, 1997 9:21 PM
Subject:        Re: baby with small oral cavity

I had a mom in the office today with 10 day old baby girl, baby's
birthweight was 7 lbs 2 ozs but the mouth seemed tiny, very shallow
palate, and I had a hard time getting baby to extend the tongue (there
was no tongue tie). Mom complains of sore nipples, although they don't
look cracked. Baby has sucking blisters on lips, dad said he'd been
cutting the skin (!) so the baby wouldn't swallow the dried bits....Eek!
Mom is very uncomfortable throughout the feeding., it doesn't get better
after let-down, she says.  Dad acts as translator, but I think some of it
is cultural,  he is the spokesperson, bec. mom seemed to understand
everything I said, and said a few words in English. (the dad's mother sat
in on the session too!) The family is Indonesian...
 Her breasts were very full and firm, but the nipples were NOT flattened.
Nor were they flattened or compressed  after baby came off the breast.
Well, the baby didn't  exactly come off the breast, we had to pry her
off.
How do I get this baby to extend her tongue? Her tongue kind of sits
behind the lower gum ridge, although it can come forward.
I suggested that they soothe the baby in the prone position, perhaps
gravity will help lower the tongue, and to do "finger walking" on the
tongue.

Thanks.
Pearl Shifer, IBCLC