Very difficult case. I forgot to write the details down but basically C/S birth 5 wks ago after 16 hr labor "failure to progress" I think. Baby was not nursing well in hosp (don't know details of this) so he got bottles the first night. ARRGGGGHHH. Then baby wouldn't latch. Acts like "aggressive non nurser" in Breastfeeding Answer Book but will cuddle upright on mom and betw. breasts. Will not nurse w/ nipple shield either (like someone recently said the breast refusers don't usually take to this either). Does not do the "classic" "nipple confused" behav. either, nor has the usual nip. conf. correction techniques worked. Positioning etc taught to mom. She is extremely motivated to bf exclusively. Noted tight LABIAL frenulum, and upper lip curled in won't flange. ENT doc agreed and clipped. No improvement. Suggested "babymoon" w/ cosleeping, cobathing and the usual don't force him techniques. Also to try bf when walking, rocking, sling etc. Checked for broken clavicle, hip clicks, clefts, etc. Baby does not seem to be in any pain. Muscle tone appears normal, i.e. not hypo or hypertonic. Mother states baby sounds a little congested pc. No nasal blockages. Cannot visualize uvula as I want to check for bifid uvula which could mean submucosal cleft. (Should you be able to see this w/ penlight when baby cries? I even looked w/ a tongue blade and could not see the uvula. Is this significant? Sorry, guys, I hate to be invasive but at 5 wks mom is at wit's end.) I did not auscultate chest, but color, perfusion, wt gain is good. Reports consistently faxed to MD, no abnormal findings per her. Suggested SNS to give quick flow and reward when baby briefly latches; mom has not tried this yet, altho she has one, doesn't feel ready to do so, even now. Referred to speech pathologist who has exp. working w/ bf babies. Saw x 2 visits. Everything found to be normal except sl. receding mandible. Oral motor function, suck, etc assessed to be WNL. Baby still staunchly refuses to bf. He will latch very briefly (not w/ shield) and cries, kicks, punches quickly. Mom is now 5 wks pp and has now accepted my recommendation to see chiropractor who does CST and works alot w/ babes and children. I also suggested she may want to see another LC who may help her better than I. I gave her the names of several I respect. Baby has always and continues great wt. gain on expressed ebm only. Mom using PNS pump from the beginning. Any suggestions from you, oh wise ones? Or can anyone send a magic wand my way? Laurie Wheeler, RN, MN, IBCLC Violet Louisiana, s.e. USA ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html