First--THANKS MUCH to everyone who was so helpful in giving me ideas in
working with this baby and his family.

The little fellow that I posted about around the end of December has
been making a great deal of progress, slowly but surely!  And you know
without the great encouragement you folks gave, I think we might not
have made it to this day.

The finger feeding helped to begin teaching him that his mouth could
provide a pleasant experience.  Bottle-feeding was causing him to gag
and choke, breastfeeding was impossible because he wouldn't open his
little rosebud mouth enough to even drop a drop of BM into!  Someone
mentioned using an ice cube to chill mom's finger and stimulate the
baby's tongue.  This really worked wonders for this little guy--and I
think it really is sort of a highlight for the whole family, a funny
treat in the midst of such serious work!  He really took an interest in
this activity and began to open his mouth and eventually even began
sticking his tongue out a little.  Today he even seemed to be flirting
with me, trying to get me to stick mine out, too.

About ten days ago mom began using the silicone nipple shield so that
baby would attempted to draw nipple into his mouth.  With this he would
draw nipple in shallowly and then neatly tuck it up into the fairly
highly arched palate, and fold it.  Poor mom kept working at it, inspite
of the discomfort and abrasions she was suffering!

I counseled her that there was no need to rush this, that everything
would work better if she continued helping him to learn to draw nipple
back into mouth.  Over the past week, she has managed to work into
almost full-time breastfeeding using the nipple.

Today when I arrived, she told me that he had breastfed all day
yesterday, her nipples were no longer hurting very much, but that he was
still clicking.  As we talked, I suggested that he might be able to do
better if he could draw the bare nipple into his mouth.  Told her about
starting the feeding with the shield and then removing it when he seemed
willing to release the breast.  About that time, he began to act hungry,
so she asked if she should try it now.  I said sure.

Well the little fellow quickly took the nipple shield and worked it with
a lot of clicking, but he was clearly getting milk.  We tried "Dancer's
Hand" positioning and were able to stop the clicking, and he was willing
to continue nursing.  Then he released the breast, mom quickly took the
shield away and he went back onto the breast without the shield.  He
spluttered a little, but soon had a very good latch.  Needed to continue
"Dancer's Hand" positioning to keep him from clicking, but mom reported
no nipple pain at all!

Hurray, Hurray!  Nearly four weeks and ten home visits later. . . Thanks
for your support.  We all celebrated here in Carson City today.
Melinda Hoskins, MS, RN, LC2B
Family to Family Visitation Supervisor

Oh, our new Republican governor is not removing us but targetting our
program for downsizing under the next biennial budget due to projected
budget shortfalls.

About 10 days ago he began taking