Karen, Sounds like this baby is using all negative pressure to bottle feed - drawing in the cheeks - and no positive pressure. (you said the baby was full term and has normal buccal fat pads, no?) If the tongue does not move during sucking, the baby might not be able to move milk from the Haberman. One advantage of using the Haberman is that compression works better than suction, and it could help encourage the baby to try to use the tongue, especially if the jaw were stabilized with a Dancer Hand position to help isolate tongue movements. One can do this with bottles by using the thumb and first finger on the baby's cheeks, the jaw in the webbing between the thumb and finger, and the bottle resting on the palm of the hand. Takes a tiny bit of practice, but works well. The other way to do this is to hold the bottle in the webbing between thumb and finger, and bend the middle finger 90 degrees, and place it under the baby's chin. The second method is usually more comfortable, for me at least. I'm not saying that the mom should be nagged to use a Haberman if she is uncomfortable with it, just sharing the clinical judgements I'd weigh out for this baby were he my client. Another possibility is a pigeon (Japanese brand) cleft palate nipple. It fits on standard bottles (are Australian standard bottles the same as American standard bottles?) using standard rings. That might be more cost effective. It only requires slight tongue elevation to spray milk out of this nipple. If the tongue is short (which often is the case when the lower jaw is small) bring the jaw into the mom's breast by extending the baby's head (sometimes rather strongly, since their soft palate and epiglottis are in closer contact than an adult's they can still swallow in this position) at breast. Sidelying usually produces the strongest extension, especially if the baby's lips are placed south of the nipple so he extends the head and opens wide, and as soon as his upper lip clears the nipple, baby is snuggled close by mom's hand at the center of his back (mid-thoracic area). Catherine Watson Genna, BS, IBCLC NYC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html