Hi Marie, I suspect the following scenario here: Baby has a hypersensitive mouth/gag, so refuses to pull the breast to the junction of the hard and soft palate, and chews the nipple, forming that nice little pocket in the palate, which reinforces the poor latch since the nipple fits there so well. The poor latch causes the tongue to be unstable (because the mouth is not full of breast), so the suck is lousy. If the root of the problem is truly a hypersensitivity, there is a neat little trick some OT's use: before feeds, put firm pressure on the posterior surface (inside) of the upper gum with a finger, then slide the finger slowly back along the palate as the baby accepts it. The firm pressure to the alveolar ridge seems to increase the ability to tolerate oral stimuli. In this baby, the proper area is probably the front of the bubble... The mom can do this while fingerfeeding, as food increases the acceptance of stimulation as well. Then move to the breast to end the feeding. Some kids need only a little bit of fingerfeeding before they can move on to sucking well at breast. Also look for a tongue-tie, not your typical tight at the tonguetip one, but a restriction farther back that allows freedom of movement of only the tonguetip, but not the main body of the tongue. This is another scenario for bubble palate formation, when the baby elevates the tonguetip against the front of the palate, but can't get the midtongue up there, so the only part of the palate that explands is the very front. I saw a very clear example of this today, didn't have the heart to ask to take photos because mom was upset that I recommended they see the doctor...hate that part of our job. -- Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]