Am working with a newborn about one week of age, she has great difficulty
with latch. (posting with permission) She has a strong tongue extrusion when
attempting to feed, her gape is fine, she accepts breast, then seems to push
it out.  In my experience, often these little ones become a little more
organized with time.  However, on further inspection, she has extra tissue
running the length of her gum line bilaterally beneath the tongue.  This is
not obvious unless one looks beneath the tongue.  The tongue moves
independently of this tissue and looks quite normal, the extra tissue itself
is anchored to the gum and flaps medially.  Hopefully this makes sense to
some of you.  I have not seen this before.  It looks like this extra tissue
limits the inferior range of motion.  There are no other anomalies evident.
Her pediatrician is also stumped.  A referral has been made for further
medical evaluation..
Currently the mother is pumping and bottling,  she cupfed in the hospital
for a few days,  fingerfed for a few days, it all became too cumbersome for
her.  A nipple shield was attempted, but was unsuccessful.
Mother is skin to skin as much as possible and attempting breastfeeds when
baby is willing -but at this point feeding EBM via bottle is her primary
feeding method.
Am appreciative of any knowledge which may be of help here.
Thanks,
Katherine Abdun-Nur RN IBCLC
Oregon, USA

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