Val,
    What's this baby's *tone* like?  I wonder if it is a problem of poor tone, or a problem of needing calories?
    As for calories, expressing and using a tube device to supplement at the breast (Supply Line or a cheap, do-it-yourself model) sure beat a bottle anytime.  Artificial  teats are best avoided, as none of them provides an identical oral experience to the real thing, and there appears to be a tendence to use them longer, compared with other interventions. 
    IF this baby has poor tone, and the upper lip situation suggests that is a possibility, an assessment is in order.  If it is *just* the one side of the upper lip which is atonal, local stimulation of this may help (I well remember one such baby).  However, from the rest of what you said, I suspect a full examination of the baby should be done - neurologist, or speech pathologist, or both.  Meantime, it is important to make sure the baby is getting calories, which might not be happening with the sleepiness and poor tone.  I would suggest:
   - switching sides repeatedly, i.e. 3-4 "sides" per feed
   - feeding tube device for supplementing while at the breast
   - local stim. of the problem side of the upper lip
   - a neurological assessment  (but get those calories in, in the meantime)
   - adjusting attachment/latch, so that the baby can feed as efficiently as possible
   - using "dancer's hand" technique to support the baby's chin and lessen the energy he needs to use ("dancer's hand", without a name at that stage, has been round in Queensland since at least the early 1940s, and I was taught it in 1965).
    - lots of reassurance of the mother
   I'm sure you'll get lots of other helpful suggestions from other Lactnetters, a generous group of people.
   All the best in helping this mother-baby duo.
          Regards,
               Virginia     [log in to unmask]
                
     

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