Anna asked, "Any ideas or suggestions? Mom has made peace w/baby not bf. 
Baby now
takes 4-6 oz bottle every 3 to 4 hrs and is now able to maintain sucking
unless she is tired, when mom reverts to pacing. My hope is that when
baby starts solids, perhaps mom could transition to sippy cup and see if
baby will bf once she is no longer sucking on a bottle."

My suggestion is for any baby who can not maintain feeding, whether bottle 
or breast, to see an experienced Speech Language Pathologist who understands 
and treats infants. Other issues I would refer to an SLP are: poor lip seal, 
too strong gag reflex, unable to handle a normal flow of milk, tongue 
thrusting, low stamina (where baby can not effectively remove enough milk to 
provide caloric requirements), etc.

What I see in my practice is that most bottle babies learn not to suck --  
they merely swallow what is flowing into their mouths. This is why it is 
often so hard to transition a bottle baby to the breast -- they have to 
learn to suck actively to transfer the milk. Often bottle babies are only 
taking in the tip of the nipple (look at the photo of the baby on the Avent 
bottle with the deep latch almost to the plastic ring that holds the nipple 
on). Some can only grip their lips with a narrow gape.

Kathy Eng, BSW, IBCLC 

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