I've met a few babies who have narrow but patent nares and have trouble when
breastfeeding, but not when bottling. What I notice is that a poor latch at
breast both overflanges the upper lip and pushes the upper lip upwards so
that the nares are both narrowed and slighted occluded. This can usually be
resolved with an offset latch with very wide mouth (lip cannot overflange
and is not pressed upward). A bottle doesn't cause these problems.
Changing the angle of the baby's head at breast can give immediate
improvement - more neck extension and definitely no pressure on occiput!
Joanna Koch, IBCLC, N Ca
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