Helen wonders about soft nipples....

I've seen babies not recognize the nipple/teat in their mouth, mostly after
their mothers had an epidural. My theory:

These cranial nerves are involved in sensory and motor function surrounding
the palate: Trigeminal (VI), Facial (VII), Glossophyaryngeal (IX) and Vagus
(X). In addition, the Hypoglossal (XII) controls tongue movement, and Spinal
Accessory (XI) controls the sternocleidomastoid and other muscles needed for
the suck-swallow-breathe triad.  Epidural medications numb the mother's
nerves - that's why they are given. They also cross the placenta.

1) The sensory nerves in the palate are affected by the medications, causing
the baby's palate, lips, and gum ridges to become somewhat numb. Therefore
the baby does not respond with sucking even when presented with an excellent
breast.

(1) The nipple tips are somewhat more fibrous than the rest of the breast
for some reason. Possibly they stimulate the sensory nerves in the palate
better, which trigger or are related to triggering the suck response. With
soft or tiny nipples, they are "missed" by the baby whose oral sensory
responses are dulled or compromised.

This is why I think some of these babies will respond to a bottle/teat or
fingerfeeding but not to a breast: the stiffer finger or artificial teat
provide a stronger stimulus to the palate which can trigger the suck
response. It takes time for these medications to wear off or be metabolized
by the baby. Meanwhile, the baby can become imprinted on the stronger/firmer
stimulus of the object and may have difficulty transferring back to the more
subtle stimulus of the breast/nipple. We still need to FEED THE BABY, but
the choice of method has profound implications!

Now, consider that many of the cranial bones move out of good alignment
during birth and therefore can impinge on one or more of these nerves. This
can make the situation worse... but that's another long story for another
post.

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com