I have recently seen several babies with poor latches, two of them had a
tucked lower lip that was hard to work with, the one child was receiving
lots of pumped breastmilk and we switched that child to an Avent nipple with
almost immediate improvement of latch and muscle tone for the baby, although
the switch took a day or so, the baby did not like the new nipple at all.
The other infant is doing some better, mom had badly abraded nipples, one
was healed enough to feed infant with even with the tucked lower lip, the
other one was still being pumped.  Again we have improved this infant's
latch with some finger training, a switch in nipples.  Although this poor
baby now has thrush and we are trying hard to keep it external.  The problem
is pacifiers, this mom wishes to use one and I can't find a wide based
pacifier at the local store.  Avent's pacifiers are not better that I can
tell and we want this infant to keep his mouth opened and lower lip flanged.

Any suggestions?

Pat Thomas PHN IBCLC
Winona County Community Health
Winona, MN

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