Many thanks to all of you who responded, publicly and privately to my post on
baby W.  After speaking with mom last night, she has decided to pursue the
following plan.

1.  Try the various MER management techniques again.
2.  Visit a new GP, in hopes of getting a referral to an ENT.
3.  Travel to Sydney for a pediatric OT evaluation.  They will give her a
referral, if necessary for a SLP evaluation.

In the meantime, she is now feeding exclusively at the breast, with the
nipple shield because she feels it helps protect her from W.'s pinch after
the first few minutes.  Her supply remains fine; W. is gaining at least 200 g
and growing a cm each week, and when he's not feeding, he's a happy little
guy.

I'll keep you all updated.  If I can dig myself out of the mountain of paper,
I'll post about 2 other challenging cases from this week.  Apparently, I
didn't get the memo.  Someone must have declared it "Impossible breastfeeding
problem" week here in Canberra.  These two make W. look easy!

Cheers,
Barbara Ash, IBCLC
Canberra Australia

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