Liz,

I would agree with Rachel who asked if you've seen baby bottle feed for the 
babies I've seen who are nasally congested with breastfeeding also have some 
difficulty with bottle feeding, and these babies are usually tongue tied 
(posterior type) with very high palates.  Sometimes the nares are quite narrow also.  
A submucosal soft palate cleft should be ruled out also; any milk coming out 
the nose with feeding?  An ENT evaluation might be a good place to start.   
Congestion with feeding generally means microspirations are occurring.  Having 
mom nurse baby with exaggerated head extension and in an upright position would 
give baby a bit more time to organize bolus formation before swallow (a Cathy 
Genna wisdom); also mom could try expressing  her breast a bit before feed so 
the milk flow is slower and easier to handle for baby.

I would be glad to send you the relevant posts I've saved from Cathy (from 
whom I've learned volumes) and ditto from Barbara Wilson-Clay. 

Barbara Latterner, BSN, RN, IBCLC

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