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??