I have a case study that I would greatly appreciate any and all feedback on.

I have a mom G3P3 who delivered 12-24-95 an 8#12oz girl in a facial presentation
(yes mouth and nose first, ouch!), over a pitocin augmentation, with a
subsequent rapid descent and delivery.  Home in 6 hrs and nursing on demand q2h,
mom reports nipple pain at first nursing. Consult at 2 days showed an inpaired
suck with tongue "bunched up" in back of mouth and tongue thrust when you tried
to pull it down, then it would immediately recoil.  Started suck training.  At
3wks wt #8.2oz and
MD labelled FTT and we started the pump, supplemental system, and baby scale.
Mom was extremely adversive to mechanical devices.  Mom is also tandem nsg 3y/o
(this is her second child tandem nursed), which we greatly limited access to the
breast during this time for the older child.
Baby has done great with the sns and is up to 11.5!  The problem is she still
cannot nurse properly.  Yes, we've tried positioning, artificial nipples
(recommended by another person, I'll save this for another discussion.), suck
training, and chiropractic (which has made the most improvement so far).  We are
now, after much reluctance on the mother's part seeking the advice of an NDT
(Neuro Developmental Therapist).  Without the supplemental feeding (cup, sns,
fingerfeeds) she cannot take in enough on her own.  Mother reports baby's head
appears to shift more to the right at times, and feedings are great sometimes
(86ml), but she tightens up days after chiropractic adjustments (he did find her
jaw was "shifted" and adjusted it), and
only takes in 14ml, or so.  I'm very concerned that
she hasn't made any improvements for several weeks.  She appears to be normal
and healthy, mom is doing a great job.  Where can we go from here?  The baby
loves to nurse she just can't get enough on her own.

Sorry this was so long!
Suzanne Wright RN,BSN,IBCLC