Kathy Bruce, If this were my client, I would have advised getting this baby off the breast and mom pumping very early. Sounds like the baby had a terrible suck. In situation like this, when direct effective breastfeeding isn't happening, go for indirect feeding of mom's milk until the problems in both are fixed. Get mom pumping and feed the baby with another device while each is treated separately - mom for the nipple stuff, and baby for the poor sucking response. Keeping an ineffectively-feeding baby at the breast is counterproductive. You know the old adage - if it's not working, try something else. Linda Smith, private practice in Dayton OH