Very interesting case I saw today. Mother of preemie, dob 8/31/95, 2. 10 lbs released from NICU on 9/27/95. Mother states he was evaluated once by an OT and that she does exercises with him daily. He has never been offered the breast (we really don't know why) and she presents today, not because she wants to BF but because she thinks she is losing her milk. This is a 43 y/o white female who states she was an infertility patient. She has recently moved and she has been on a weight loss diet, and success- fully lost 18 lbs in 2 months, thank you very much. Today the infant weight 6.10 oz on M...scale. Gentle prodding of the chin to elicit open wide mouth reveals aversion behavior to any oral stim. I asked the mother to show me the exercises. She forces her finger (with a nail about the length of four of mine-that's long) into his mouth and demonstrates what she terms a "gum massage" which she states the OT told her to do to unglue his tongue from the roof of his mouth. I asked if I could offer him his bottle (with a NUK on it) He would'nt let me in. I played and talked and sang, and gently asked to come in his mouth, he opened and let me assess. I found the palate to be wnl, and the tongue retracted way back, occassionally trying to push, then troughing ever so slightly. I asked my assistant to hurry and draw up EBM in a periodontal syringe and he sucked rhythmically and really enjoyed the feed to the joy of his mom. She had come in with a cocky sort of attitude. Somewhat challenging me, just what can you do? She left knowing 1. She should have a reevaluation by a OT-i will find one for her..2. She has thrush, that's why her nipples hurt and are flaky red and inflammed and 3. DC her exercises, and 4. DC Dairy in her diet (this babe was so congested) and 5. How to pump and stop dieting! I was challenged. Never saw a baby with a bite like this before! I mean he really bit down hard-I turned my finger over, gently pushed down on the tongue, and when he suck returned to a nice rhythymical suck/swallow, I gave more EBM. He got nice and sleepy and was so content not to struggle with his bottle. Mom was impressed at the efficiency and especially with his demeanor. Now I have to find a really good OT in S. Florida-HELP LACTNET!