Dear Denise and all,

Anne and I have been trying to find the time to get back to you after a week
where we've had biting babies falling out of the heavens. (Funny how you get
batches of the same problem sometimes!)
We find that the answer generally lies in discouraging the biting by
* correct the attachment where necessary
* fairly firm index finger massage directly over the temporo-mandibular
joint (TMJ), with the finger staying on the same patch of skin and with a
circular motion (done with care - it is possible to dislocate baby's jaw!)OR
if necessary,
* applying downward pressure on the baby's chin at the breast, using a
finger or thumb until the baby releases the "bite".

The severity of the problem is no indicator of how receptive the baby will
be to change. We have had some babies who stopped biting permanently after a
few minutes with the above approach, a few who have been totally
unresponsive to any change, and others who have continued to need some level
of "reminding" for days or weeks afterwards, but who have eventually fed
quite normally.

We have associated biting with poor attachment (struggling to hold what
breast they have in their mouths?) and with under supply/slow flow. Anne
thinks that there are probably a number of different mechanisms involved
with this problem - it is not necessarily just a conditioned response. A
good example of what Anne suspects is this current case:
2 week old poorly attached and a severe biter - mother with sore nipples and
quite severe breast pain. Corrected attachment allowed nipples to heal, but
breast pain persisted because baby very loath to relax TMJ. By 4 weeks,
mother has decided to wean. The only situation in which this baby fed
without biting  was when mother allowed baby to use its infant reflexes to
crawl naked up mother's semi-reclining body to breast and attach itself and
feed. (We suggest they do this in a bath with enough warm water in it to
keep them both warm). She said that if she could just live in the bath she
could see that she'd be able to breastfeed! This case highlights for us the
importance of having all the necessary neurological hook-ups in working
order. Unless this baby had her normal responses reinforced by this exercise
immediately before feeding, she could not sustain these responses and feed
without biting.

As a team, we really enjoy the multi -disciplinary input, particularly in
such unusual situations, and it is heartening for us to find such a
diversity of backgrounds shown in the mail we are reading here. Just
diverging from the above topic, we would like to say to Yaffa with her
problem of "professionalism": Well done and hang in there. You'll be able to
offer them so much, so, sock it to them!

Anne Bovey and Robyn Noble. Brisbane, Australia.

PS Greetings and salutations, Lesley McBurney! Is this enough challenge to
tempt you ?!