Hi Kathy, Congrats on your up and coming practice!

Kathy writes;
>>Used inverted syringe to pul=
l=20
nipples out for each feeding--could get him to latch deeply more and more=20
often over the next several days...but then he would "slip" down on nipple=20
later in the feeding.<<
The fact that he slips down on the nipple later in the feed sounds strange to
me.....particularly if it is much later ie. some babes will not suck long
enough and hard enough to seemingly "hold" the latch in place, the 10-20
sucks or whatever it typically takes and the nipple slides back but THAT
occurs obviously in the first minutes of the feed. It sounds to me as if this
baby is achieving the latch but that several minutes later the nipple either
all of a sudden slips or slowly slides back. ?  You didn't really say but how
"tight" is the nipple tissue? This is also a huge factor with this type of
nipple. The babe obviously has to suck longer and harder before achieving
latch on the taughter nipple.
At any rate, if it is several minutes into the feed, I would focus on
positioning. If the baby is positioned in such a way that encourages him to
open wider and take more of the breast with every suck then nipple sliding
should be less of an issue. What I might expect to see with this type of
presentation is a babe that is "tight" and good sized, thus more difficult to
positon anyway, hates to open and clamps ferociously with latch but with
compression (you didn't say whether you used it) will move to a deeper, more
relaxed latch.
As for the Haberman vs. finger feeding or whatever, I would be very reluctant
to let this baby suck on anything other than the breast at this point. He
needs the practice at the breast. What about cup feeding?
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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