Sounds like you've tried a lot of good strategies. Another thing that
might help is to prefill the nipple shield with milk. Once the shield is
secured deeply on the breast, you can fill it from the front holes with
a curved tip syringe. Mom can then offer baby the breast, preferably
while she reclines so baby can be prone. They might be able to have baby
in a straddle position, so the baby comes up and over mom's belly,
which can allow more head extension.
Has the ENT looked beyond the baby's mouth to the airway? The stridor
and noisy breathing could be due to poorly coordinated swallowing due to
the tongue issues, but it could also point to a respiratory malformation.
Catherine Watson Genna, IBCLC NYC
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