Tip #2
We have a 3 month old with BWS and have found that Nuk nipples work well with her.  Have you tried a Nuk size 1 nipple with a slow flow?  We have tried these with our daughter and they seem to work well.  Does your granddaughter have a sucking problem?  Our OT has also worked with our daughter in the correct positioning of her upper lip.  Since she uses her tongue instead of her bottom lip to suck, positioning her upper lip around the nipple helps to create more suction.  Also holding her chin up to help keep her tongue in helps her suck better.  I hope this has helped you in some way. 

Tip #3
It was a long time ago, but I remember using a criss-cross cut nipple and that worked fairly well. 

Tip #4
My daughter had a lot of trouble feeding when she was first born, and that was due to her being 8 weeks premature and having a large tongue. During her stay in the NICU, the team of physical therapists showed me how to hold the bottle with my right hand at the same time using my right thumb and index finger to hold in her cheeks. With my left hand I reached around and pressed upward on her chin so that she was able to get some suction. I pumped breast milk for her the entire time she was in the hospital, however on the day I brought her home I tried feeding her directly from the breast and she did great. The downside was that I still have to hold in her cheeks and push up her chin and it would take her a very long time to get a full feeding. After a while of that, I went back to pumping and gave her milk from a bottle with the NUK nipple others have mentioned. She was able to get the larger nipple further into her mouth and that let her "strip" out the milk better. She's now 8 months old and can use regular nipples with no extra assistance from me. Ask a physical or occupational therapist to show the baby's mother how to coordinate her hands to help with the feeding. It made all the difference for us.

Tip #5
After trying out endless bottle nipples and being near tears ourselves at each feeding, we finally found a nipple that worked well for our daughter (Pur) – and she was able to maintain an average growth of ~250gr/week until the growth curve naturally began to decline as she got older. All we can say is that nipples such as those which use more holes (those which are based on creating a vacuum) rather than bigger holes to increase the flow are not appropriate for babies who use their upper lip together with their tongue to suck. Our daughter was completely unable to get the suction right with those nipples. Just a standard nipple with one hole (we found that the medium sized hole worked well for her right from the start) is the only way to go. Nevertheless mealtimes took quite a long time for her. In the beginning it would take her 1 1/2 hours to finish her bottle - and it would tire her out completely. Now she is 7 months old and can finish a full bottle in 20 minutes with no problem and without getting the least bit tired. Keep trying until you find just the right nipple for your baby. 

Tip #6
I had trouble with our daughter when she was born.. all I ended up doing was making sure the nipples she was using were fairly soft (not so soft though as to collapse when sucked upon).. wide based.. and I had trouble finding nipple holes a good size.. before you discard all those you have though.. a simple thing to try?? take the tip of a razor and simply cut a larger hole or a small "x" on the very tip of the nipple.. squeeze it to test to see if it flows pretty good without too much effort.. because of the different consistencies of formula or breast milk and juice or water.. you'll want to keep different nipples at slightly different sizes.. that's it.. other than to just keep trying :)

Tip #7
Our daughter did not have hypoglycemia, but she did in fact take a long time to eat. It was really tiring for her and that is why it took so long.  She was on the ng tube until about three months old. (that is the tube that goes in the nose) At first they didn't give her anything by mouth and the n later they gave her  just like you said about twenty minutes and then they tubed the rest. Probably the ng tube would benefit her from my experience until she gets a little older and stronger, and develops that good tongue coordination.  Also when she was getting the tube feeding as it was going in we either gave her a binkie and held it in or we gave her tiny bits of formula by a syringe so she could associate that sucking gets her belly full, this is so important.  Also maybe you could try using a different bottle, we tried all of them.

Tip #8
We also faced the possibility of doing a feeding tube with our son (now 13 months). It would take an hour to feed him 4 ounces and I finally told the doctor I was ready to "give in" to the feeding tube. However, his doctor thought a trach would actually help him since it was more of a lung issue for him as well as the tongue, but he thought if he could breath easier then maybe he could eat better. Well the word trach made me very nervous, so I told the doctor to give me another week, I would feed him an ounce an hour if I had to. I went out and bought every nipple I could find and I finally found one that worked with his tongue. It's the Gerber one piece nipple and ring, since the entire ring and nipple are made out of a soft rubber, he could get his lower lip around the ring and fit his tongue in the groove of the ring where the nipple met. Now, I know that others in the group have tried other nipples. This may not be the solution you need, and I have heard that a feeding tube isn't all that bad, at least she would be getting what she needs. I do encourage that if you do a feeding tube, don't forget about her oral stimulation she needs to correlate food and eating.  When our son was in the NICU and had a NG feeding tube, I made sure every time he received his milk I would hold a pacifier in his mouth so he would put two and two together.  He didn't have the NG tube for long and did very well (at first) with breast feeding, again his issues were more about his lungs not that he didn't have the mechanics.  I just had to find the easiest way for him to eat and breath at the same time.

Tip #9
My daughter is 4 mos. old (2 mo. premature) and she had very low blood sugar. She was hospitalized for 5 weeks. We check her blood sugar twice a day and we were told to take her to the hospital if her blood sugar went below 50. Luckily, that hasn't happened, although it came close a few times. We have been extra diligent with her feedings. Her tongue is larger than normal and she leaks out a lot, but we have been successful in feeding her adequately. I also found a bottle called a "podee" at Toy's R
US. (also go to podee.com). It is a self feeding system that works quite well for her. It works kind of like a pacifier with a bottle attached. I think because she is able to control the flow herself, she leaks a lot less. We still feed her with regular bottles, but she seems to manage to eat a lot more with the podee. She took in 8 ounces yesterday! That was a record. I wrote to them and they sent me two bottles for free. 

Tip #10
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