When babies have long inefficient feeds, of course it is because they are unable to nurse effectively. Tongue-tie seems an obvious thing, however there can be so many things having an impact on feeding ability. For example, facial asymmetry, slight hypotonia, unilateral smaller nare ( often seen with assymetry), slight laryngomalacia or related anomalies, etc. And then there can be infant mouth to maternal breast disproportion (large nipples, small mouth), and suboptimal milk production (which often ensues due to early , infeffective feeding. 
I agree with Pamela re the strategies she suggested, e.g. breast compression, switch nursing, keeping feeds reasonable in length and then comping with pumped milk after. Often babies need extra volume for catch-up growth.

Here is a question about breast compression. My understanding was to compress the breast when the baby was sucking, in order to increase the milk transfer and keep the baby drinking. Then to release the compression during the pauses and when baby starts sucking again, compress again. I think this works, it’s how I do it and teach mother. However, I see that someone else said (Pamela?) to compress during baby’s  pauses to get him drinking again. I think both ways could work, but which do yh
you think might work better?

Laurie Wheeler RN MN IBCLC
New Orleans LA and Mississippi Gulf Coast, USA
Sent from Mail for Windows 10

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