Hi everyone,
I have an interesting case to share.  Baby delivered on May 29 , mom's second
baby.
She nursed the first child for 7 months.  In hospital baby would attempt
latch but never stayed on.  After discharge mom sought out another LC who got
her an electric pump and her use a Haberman nipple.  At one wk old I saw baby
for first time.  Baby very frustrated at breast even though mom had large
errect nipples and plenty of milk. Baby had good suck with digital exam.  My
assumtion was nipple confussion so tried nipple shield but baby still didn't
stay latched on.
Several days went by with mom continuing to attempt baby at breast, he would
start to suck then come off.  On the next visit with me I noted the baby to
be very noisy with his breathing but resperations WNL.  Baby eagerly went to
breast but after a couple sucks would pull off.  We tried the shield again,
same thing - great positioning and latch but after couple sucks pulling off.
 Mean while mom's milk is pouring on him.  I then observed him with the
Haberman - he did fine.  We then tried the cup and he did not do well with
this mode either.  Through the week-end his breathing became noisier so she
made appointment with pediatrician.  He found the palate intact then he
checked the naries with a french cath, he could easily pass it in the right
side but could not on the left.  When he plugged the right side there was a
small amount of air exchange.  He is being set up with a pedi ENT to do
further evaluation.
This baby knew he could not swallow and breath so instinctively would pull
off.
I'll keep you posted.

Ann Perry RN IBCLC