First day back from vacation and faced with a challenge.  One day old
infant opening mouth wide, but unable to obtain a good latch.  On oral
exam, infant's tongue arched or "humped" posteriorly.  Anteriorly tongue
seems to be lying flat.  Encouraged mom to allow infant to suck on her
index finger a few minutes prior to attemping latch-on.  Mom questioned
if a pacifer might help to improve tongue positioning, but I thought
that the shorter length of the pacifer would not help the problem and
maybe even make it worse.  Incidently, this mom did have an epidural,
althought not for a prolonged period of time.

Actually, just before I left on vacation two weeks ago, had a similar
challenge with an infant whose mom also had an epidual,  but for an
extended period of time.  My partner worked with this mom as an
outpatient and eventually mom was able to get this infant to latch with
the use of a nipple shield.  She continues to nurse with the shield.

Any other suggestions or positoning stratagies?

TIA, Judy in Upstate NY

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