I think occupational and speech therapists should both see this baby, perhaps physical therapist as well. If you can get the baby referred for early intervention, they can all take a look at the baby as part of the evaluation. Tongue thrust to this degree is not normal, and can be associated with neurological deficits. That and the posturing the baby is doing could be significant. I imagine you already checked for torticollis... If baby seems to be floppy, that would increase your index of suspicion for a neurological issue. The last baby I had in my practice that used strange body positioning like this turned out to have a genetic disorder that caused oral motor and neurological dysfunction. One thing I might try is to pre-fill the shield with a little milk using a curved tip syringe (the tip fits right in the holes) to see if a more functional sucking pattern can be elicited. Using an SNS or Lact-Aid under the shield might also help. Anything that gives this baby a reward for trying to make the breast work can result in her getting it right by trial and error. Keep us posted. Catherine Watson Genna, IBCLC NYC *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]