Dear Joanna,

I too have had plenty of babies with the same essential
problems of not opening, tongue poorly positioned etc. Through
the years several pattern keep recurring of which deep
suctioning is one. Other risk factors that I've noted are
excessive mucous, vacuum extraction, precipitous deliveries, and
endotracheal visualization
at birth. I find a combination of skin to skin, oral exercises
with the infant, and TOT (tincture of time) will eventually lead
to success. I try to tell mothers of these babies that their
baby is just not ready to breastfeed, but it is important to
start pumping and giving of EBM. I've had most babies go to the
breast within two weeks - if mom is willing to hang in there.
Unfortunately, you can't tell how soon these issues resolve and
some moms lack support in trying to continue.

Sorry this is so long. this is such an area of interest to me
that I am currently researching poor LATCH scores in our
hospital and the intrapartum experience.  (Long and tedious!!!)

Just FYI - one of my success stories from several years ago.
Had a baby who had been intubated at birth for meconium and
literally would not suck ( on anything!!) Baby would open mouth
position well at breast and not do anything except mouth the
areola or anything else offered. Finally at 4 days post birth,
mom dripping with milk suddenly the baby began to swallow adn
attach normally.  Could I have been seeing a temporary paralysis
of the muscular structures due to a traumatic intubation ??? I
find more than anything else when babies don't nurse well right
away, mothers  want answers that make sense and give them
reassurance to hang in there.  This whole lack of latching on
lends itself to lots of research. Any takers??