Remember that Feeding and Swallowing Disorders in Infancy is copyright 
1992. There's a lot of great information in that book, but there are 
also some things that are now understood differently.
Neck hyperextension in concert with scapular adduction does put stress 
on the tongue, drawing it back, but with shoulder abduction (the 
comfortable position that happens when baby is allowed to "hug" the 
breast) the tongue comes forward more. Basically, babies should not be 
forced into awkward positions!
Cathy

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 3/24/2012 1:07 PM, Laura Spitzfaden wrote:
> To increase my understanding and because it is fascinating, I am reading _Feeding and Swallowing Disorders in Infancy_.  I am pretty sure this book was recommended by someone at Lactnet.  I am finding it very informative but confusing.  In several instances, I am reading that it is important to *flex* the neck during feeding and that hyperextension and even extension functionally retracts the tongue.  This is opposite to what I have learned.  Obviously neck flexion will draw the jaw away from the breast making it difficult to latch, but I also was under the impression that flexion retracts the tongue and extension allows the tonge to move down and forward, especially helping the baby with tongue-tie.  I recognize that the book mostly covers bottle feeding but that shouldn't affect the claim that flexion allows the tongue to extend and extension retracts it (opposite to what I have learned).
>
> Also, when showing a friend who is a SLP a picture of hyper-extension of the neck and prone positioning of a baby with Pierre Robin Sequence, she thought it was opposite of what was needed to help him feed.  Can anyone with breastfeeding and SLP experience (or anyone else with the background knowledge) clear this up for me?
>
> Laura Spitzfaden LLLL, IBCLC
>
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