Laurie, you might be coming up against moms with full breast tissue or 
edema that is difficult for baby to compress at first. This may make 
them latch to the tip. Someone else said the nipple sandwich technique 
and I use that often, along with nipple just under the nose and chin 
touching the breast. It all depends on the "fit" of mom and baby. A 
small mouthed baby, or one who has learned to keep mouth closed for 
bottles, and a mom with taut skin and "wide" breasts/areola, will often 
have a mis-match. The converse is I have seen babies tip suck until I 
show mom the chin to breast, nipple to nose technique and we finally get 
a nice latch on day 4 or 5. Also, babies with a very recessed chin (you 
see the top lip comes over the bottom lip or they don't match up 
exactly) will need more chin smooshing in than you would think. And 
remember, if you are seeing drugged babies, they may be affected enough 
to not have that "open wide" instinct for a few days and this is why the 
technique fails.
Kathy Eng, BSW, IBCLC

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