Amy -- I, too, will never be accused of brevity!

I would start by describing what is needed to nurse *without* any special
circumstances:  how the mouth must open wide so lips can form a seal ... how
the tongue has the (sustained) job of pressing the nipple against the roof
of the mouth ... how sucking/breathing/swallowing coordinate ... the
importance of negative pressure in the mouth.

Once the biologic norm is explained (and remember .... almost *noone* knows
what is going on inside a baby's mouth while breastfeeding), then techniques
for those with deviations from the norm will make a lot of sense.  Cleft
plate baby can't create negative pressure ... use Haberman bottle that works
with jaw compressions only.  Premie babies with scant bucchal pads can't
sustain negative pressure efficiently ... use nipple shield.  Etc. Etc.

Liz Brooks, JD, IBCLC
Wyndmoor, PA, USA

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