for Pat et al.

 gagginess is a symptom

        low tone and "gagginess" is common for Downs Syndrome (DS) Haberman
is a good idea to insure weight gain, most important! use the short premie
size haberman to lessen gagging.    yes speech oral motor specialist is
great (like the crew we saw in Nashville) only use silicone teats and
habermans.  alot of oral motor work needed for a low tone mouth if mom is
motivated it works I have a LLLleader who did it for her LOW tone gaggy
guy!! I'd send you to her to talk but she is "out of pocket" for undetermined
time.

The shield can only be safely used with a VIGOROUS nurser or we will only
see foremilk intake, low weight gain.  keep in touch.

IF mom wants to do only breast: lots of massage and hand compression of
areola for the baby until tone improves, it can be a looooooooooooong road
unless the baby is mildly involved.