Sarah,
I have one complaint about the Leaven article on clampdown bite reflex.  There
is no mention about tongue retraction and the fact that the bite reflex is a
normal response if something touches the "chewing surfaces" of the gums.  This
bite reflex is inhibited when the tongue is over the lower gum.  This is what
prevents mom from being bitten during breastfeeding.  When the tongue is
retracted for any reason, the baby will bite.  This is not abnormal, it is the
phasic bite reflex.  The tongue retraction is the problem that must be dealt
with.
There is a different problem called tonic bite.  An infant with tonic bite
will have great difficulty releasing the bite.  This might be happening in the
baby who will not open the mouth.  Alternating warm and cold wash cloths
rubbed gently around the face of this infant might help if it is tonic bite.
This "sensory therapy" helps the brain to normalize muscle tone. Tonic bite is
pretty rare and often a sign that there is neurological damage.
Another factor in mouth opening is the fact that tongue and jaw movements are
linked in neonates.  If this little guy has difficuly with his tongue (say a
severe tongue tie), he may also have trouble opening his mouth.  Extremely
gentle tickling with moms nipple on the center of the lower lip will cue him
to open as much as he can.
        I have also seen babies refuse to open up due to trauma from
suctioning.  Patience, gentle persistence, and lots of cuddling can help
convince these little ones that it is indeed safe to eat.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]