Hello to All, Any sage suggestions wd be most welcome with the following case: Term baby girl, born at our lovely out of hospital birth center. I was their birth and postpartum nurse, and i sent them home with a nipple shield , without which i am certain this baby would not have fed at breast. Mom has small, very high breasts without much tissue elasticity. Baby has short, tight jaw excursions, tends to arch a lot, and has been a very sleepy, slow feeder from the get-go. The birth went well, and mom received no medication. This babe is now 2 weeks old and has not made birth wt. yet (about 3 oz under today). At her last visit, after 4 days of pumping and supplementing (fingerfeeding with an SNS, parents were asked to supplement at breast, but they feel it is too much of a hassle with the shield) she had gained 5oz in 4 days. Today she'd lost 0.2 oz in 3 days. I am encouraging the baby's HCP to see her sooner than her scheduled well visit (3 days hence) to r/o any underlying illness; I've asked the parents to increase total supplement volume; and i plan to meet with them again in 1-2 days to work with the baby when she is >.awake and hungry. Baby latches on without the shield 2-3 times /day, but according to mom, sucks a few times and lets go. I've been using shields for failure to latch kids like this for at least 4 years, and never yet had a case of reduced milk transfer or compromised wt gain. But in this case i feel the baby's tight tone in the lower jaw is inhibiting a good latch. I've also asked mom to hold the baby's chin down during feeds to improve latch& milk transfer. Now, from all those brilliant and experienced minds of lactation out there, what else do you suggest? Warm (90 degree) thanks from Martha Johnson RN IBCLC, EUGENE, OREGON