Kathleen,


   * Is the baby totally clear of thrush? The itchy/burning sensations
     of that can surely cause some babies to click
   * Has the arching and hypertonic behavior desisted?  Any clue to the
     cause? What were your original interventions?
   * Have you assessed the family history of
     allergy/sensitivities/intolerances? (Baby may be itching a scratchy
     palate)

I usually try putting baby in a position that has her above the breast,
such as a rock-back foot ball hold, or having mom lie on her back and
baby lay prone on top of  mom. Such positions "force" the baby to hold
on to the breast more because they must now work against gravity. If any
of the above apply, though, they would need to be addressed before it
would all come together. I assume MER is not excessively strong?

I have noticed that some of these babies seem to gradually improve when
I am doing my digital suck assessment.  At first they are frequently
losing the cupping under my finger, but gradually they "tighten up" if
they hang out and suck for a few/several minutes.   If so, doing the
suck training you suggest until the sucking pattern settles down can be
helpful. Other babies won't cooperate with such an exercise unless there
is milk flow, such as with SNS or syringe.

Looking forward to your further reports---

Lisa Marasco, BA, IBCLC
Santa Maria, CA