Hello, Victoria.
       You mention that the parents of the tongue-thrusting baby are using an
Avent bottle.  And you also said you explained my method of bottle-feeding.
First, I appreciate that you feel the method can be useful.  I want to be sure
a detail is clear.  For some reason, quite a few people have misinterpreted
what I wrote in the article.  They think I prefer a wide-mouth bottle like the
Avent.  This is not true.  I can't tell if you suggested these parents switch
bottle type or if you suggested different positioning, so I want to be sure
the details are clear here.
       The bottle nipple I prefer has a relatively small base of only 1 inch
(25 mm.).  The baby can get his mouth around the entire base of the nipple,
which causes the *baby* to have *his jaws* wide, which is what he needs to do
for breastfeeding.  The wide base of the Avent and similar nipples is too wide
for the baby to get his mouth around, so he merely turns his lips out against
the base, but has only the short shaft in his mouth.  If baby tongue-thrusts
only at breast and not at bottle, it may be that he is learning from the bottle
that the nipple (short shaft of wide-mouth bottle nipple) should only be in
the front of his mouth, and he may therefore be attempting to keep mom's nipple
in that position by pushing with his tongue.  By switching to a nipple with a
smaller base and getting the entire bottle nipple in the baby's mouth, the
nipple goes back much farther in his mouth and teaches him that his mouth should
be full of nipple as he eats, and encourages him to also draw mom's nipple
back in his mouth.  Of course, it may be that he tongue-thrusts no matter what is
in his mouth, and that's a different story.  But I did want to be sure that
the nipple style for my method of bottle-feeding is clear.
       The type of nipple I use may help baby learn to groove his tongue,
because it fills his mouth much like the breast should, and lays into his tongue
so sort of forces the tongue to take on a more appropriate shape while
feeding.  However, if baby really can't groove his tongue around a firm object like a
bottle nipple or your finger, it may be that this baby is in need of
craniosacral therapy or osteopathy or pediatric chiropractic.  Since you say baby
can't suck on the bare breast, but needs a nipple shield, I wouldn't be surprised
if this baby could use this type of therapeutic help.  Do you have any of
these types of practitioners near you?
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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