Regarding the baby with the short, heart shaped tongue who can't get on the
breast:

First of all, a tongue that appears short and heart shaped but does not have
a short or tight freulum describes pseudoankloglosia, and may be because the
tongue is very hypotonic (low muscle tone). What is  the rest of the baby's
muscle tone like? Does his mouth hang open or can he form a good seal with
his lips? What is the cheek tone like? Can he/she suck vigorously on your
finger if it is placed far enough back on his tongue? If so, a nipple shield
may work. It is certainly worth a try. Don't forget to do Jack Newman's
breast compressions while the baby is on to facilitate let down and MER.

While I totally admire,  have always agreed with, and respect what Barbara
Wilson-Clay posts, here I must very respectfully disagree with the suggestion
to tip the head back to protrude the tongue. While you are all sitting here
at the computer, take a minute to sit up very straight. Now tip your head
back so that you are almost looking at the ceiling. What does your tongue do?
Mine drops back into the bottom of my mouth, and my jaw drops down. Now sit
up straight again and jut your lower jaw forward. The tongue follows the jaw
forward.  This is the position to try for to get the short tongue more
forward.  It's really tough to do with a hungry newborn. Stroking the tongue
in a forward motion  before trying to feed can also help. The tongue has
muscular fibers that go all which ways- which is why we can do so many
movements with it. The newborn cannot do all these movement with their
tongues, but it can go forward and back. Stroking from back to forward can
help. The dancers hand position can also help.

Good Luck,

Debbie Rabin, OTR, CLC
Los Angeles, CA