You said the baby had a spontaneous, uneventful birth, so perhaps this is way
off track, but something to consider.  I've seen a baby who had her jaw
pushed "out of whack" during a very quick delivery who couldn't nurse
effectively.  She had a very receding chin and "small mouth" (turns out she
couldn't open it normally), but the physician did not identify it as
abnormal.  A chiropractor was able to gently manipulate her jaw into place
and the receding chin disappeared, as did the small mouth and her
high-pitched cry.  I don't think all chiropractors work on the mouth and jaw,
however.  Another possibility would be a cranio-sacral therapist.

If the jaw is normal, do you have speech therapists who are skilled at
helping babies?  Perhaps this will just resolve with time, but when babies
can't suckle well on breast or bottle, there may be a muscle weakness that
could be helped.  After hearing Debra Beckman speak at ILCA two years ago I
was able to obtain grant money from our local March of Dimes and now have two
speech therapists trained in the Beckman Oral Motor Protocol.  They have been
incredibly helpful for babies who are having sucking difficulties by
assessing where the weaknesses lie and teaching the parents exercises to
improve muscle tone.

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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