Definitely sounds like a tongue/lip tie. You can google the Hazelbaker
assessment tool for lingual frenulum function for help in your assessment.
Melinda Harris-Moulton ARNP
Olympia,WA


On Thu, Feb 20, 2014 at 2:04 PM, Lisa Paul <[log in to unmask]> wrote:

> I have PTP.
>
> Saw a baby today who has not been latching. 9 days old.  Baby was having a
> hard time flanging both the upper and lower lip at the same time.  If mom
> pulled down on the chin, baby would flange both lips but when he tried to
> latch to the breast his bottom lip would roll in.    When he rooted, his
> bottom lip did not flange.  At rest, the lip would turn in to the mouth.
> The chin wasn't really recessive, the chin itself seemed fine, it was the
> lower lip that was inverted (for lack of a better term).
>
> There was also a blister in the center of the top lip.  When mom bottlefed
> EBM, if she got one lip to flange, the other would tuck back in.  The top
> lip was very red while he fed.  He also leaked milk out of the corners of
> the mouth.
>
> This mom really wants to BF directly at the breast and had difficulty with
> the first child.  I was hoping this one would be easier for her, and I was
> at a complete loss of what to suggest (outside of maintain supply while I
> do more research!)  She is going to try a nipple shield again because she
> said that he did latch on that way a couple of times.
>
> Could it be poor lip tone?  What would she do to fix something like that?
>  I don't want to see trouble where there is none, but I also don't want to
> miss something that is a problem.  Any ideas?
> Thank you!
> Lisa Paul, IBCLC
>
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