SO in the first 2 days, did baby not ever even attempt to latch?  Or did he 
attempt and fail?  I see babies who are definitely frustrated and have 
decided that there is no way they are going to get anything out of that 
breast, so don't put it in my face...period.

There may be something inherently wrong, but you are not going to know for a 
while. (When either developmental milestones are missed, or neuromuscular 
function deteriorates.)  These things would not be common, but possible.

In the meantime...have you tried a nipple shield?  Sometimes I can get 
refusing babies to go to the breast if you put on a shield pre-filled with 
mom's milk...and have a feeding tube sitting underneath you can continue to 
push milk through if he stays there. (Be sure to turn the shield half-way 
inside-out before applying to pull nipple well into it before baby gets on) 
I tell moms we need to convince him there is actually something in there! 
Often, if he comes to you hungry, it pays to give him a little in a bottle 
first, then go to the full shield.  if he goes for it, then mom can try it 
at home IF she has a helper to push the plunger on the syringe (35cc nice 
size) to keep it coming FAST.  Then, over days, they can work on slowing the 
flow, and then making the baby wait a few seconds before flow...etc.  Takes 
a lot of work, but this mom sounds motivated enough.

The shield may help not only because it feels like a bottle nipple, but if 
baby has "weak cheeks" it will hold the nipple elongated for him making it 
easier to hold onto the breast.

A bottle I have found useful in situations such as this is the playtex 
vent-aire...because the baby truly has to create suction to get milk out. 
Chewing does not work.  So mom can try that for feedings when he is not at 
the breast with a shield/feeding tube.  He may refuse, in which case she 
will need to try progressively slower nipples first to get hin used to 
slower flow.

OK--all my thoughts for now!  Good luck-

Kathy Leeper, MD, IBCLC
MilkWorks- Lincoln, NE

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