Tongue Thrusting is a forceful over-accentuation of the outward movement
of the tongue.  It can happen in high tone infants because of their
increased extensor tone, or as a result of compensatory "fixing" in a
low tone infant.  (Fixing is using excessive, concentrated muscle force
to hold a body structure in place, in an attempt to increase stability.)
        Infants with a tongue-tie can have a similar problem if the anterior
tongue is held down to the floor of the mouth.  Attempts to extend
(stick out) the restricted tongue cause the mid-tongue to lift up
("hump"), pushing the nipple out of the mouth as well.
        It is important to discern the cause of the tongue thrust, because the
management is very different in all these cases.  In a high tone baby,
one would use preparatory handling to decrease the baby's tone (rocking
from side to side, etc) and increase flexion.  In a low tone baby, one
would increase postural support.  With a tongue tie, one could use
gravity to assist tongue extension, extend the head slightly to allow
greater tongue contact with the breast, and roll the baby onto the
breast from the lower lip to the upper lip.  And of course refer for
evaluation by the appropriate professionals, in all the above cases.
        Sorry you asked? ;-}
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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