Judy,
This is a chicken and egg question.  I read in some occupational therapy
literature that a high arched palate is associated with weak intrinsic tongue
musculature (the muscles within the tongue itself that are used for sucking).
Without pressure from the tongue, the fetal palate fails to spread and remains
high.  After birth, the tongue weakness may persist.  Some babies compensate for
weakness by fixing the tip of their tongue against the nipple, pushing it to the
palate.  This understandably causes sore nipples.  I agree with you that some
mothers have more elastic breast tissue and can take the stretching more readily
than others and will have less difficulty.
        When all the positioning and latch on corrections are made with no
improvement, I have found it helpful to have the mom stroke the baby's tongue
from back to front and from side to side with a finger placed pad down flat on
the tongue.  Have her go only about half way back or she will trigger the gag
reflex and make baby uncomfortable.  She should also be careful not to just
shove the finger in, have her trigger the rooting reflex by gently brushing,
stroking or tapping the baby's lips so he opens his mouth.
        The stroking gives proprioceptive input to the muscles, making the brain
more aware of them, which increases muscle tone.

        I have also seen a channel in the palate of preterm infants who were tube
(gavage) fed using an orogastric tube.  The infant palate is so malleable, it
will take the shape of whatever presses on it.  That's one I wish I had a photo
of.
Catherine Watson Genna, IBCLC

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