Hi all I saw a very confused baby today and wonder if anyone can give me some suggestions. Baby is 3 weeks old, barely back to birth weight and has never really had a satisfactory feed. Born at 37 weeks, epidural but no other intervention. Not suctioned, roomed in with mother. Seemed very 'fussy' compared to her last two who fed with no problems. Mother realised after 2 weeks that this baby was hungry, few bowel actions but urine output ok. I watched baby feed today. Gapes wide, takes breast but then fiddles around, lets go, gapes again etc etc. MER happens quickly but baby still doesn't latch, even if milk dripping off nipple. Breast/nipple both average size and shape. Obviously manages to get just enough to avoid starving, but very unsettled and frustrated. Tried different positions etc with no result. Baby not at all keen on digital exam, tended to cry and hump tongue a little, although did one quick burst of normal sucking. Palate is normal, no tongue tie. Doesn't gag on finger, just seems not to know what to do with it. Baby has been well since birth, no jaundice, checked by Ped who felt all was OK. Mother is well, experienced breastfeeder who can tell baby is just not latching. She is presently pumping and bottle-feeding to get some milk into this scrawny little thing. I have discussed cup/finger feeding to get some positive feedback to this baby. Mother is also going to try co-bathing to get baby more relaxed and willing to try to latch. She has also considered using a nipple shield but I'm really not sure if this would achieve much. I'm stumped as to why this baby is having so much difficulty getting on to the breast, and would appreciate any suggestions or insights. Fiona Coombes Family Physician, IBCLC Perth Western Australia