Kathy Eng wrote:
"I am wondering what techniques you all use for working with those babies
who
do their tongue motions wrong on the breast. For example, the tongue motions
going from back to front, or the tongue dropping too far away from the
nipple when the jaw goes in the downward motion (not cupping the nipple), or
even when the baby hardly moves his tongue at all."

For a tongue dropping too far away from the nipple, I have found gentle
pressure/support, under the baby's chin at the base of the tongue, during
breastfeeding to be helpful.  Have the mom put her finger under the chin,
outside the babies mouth, before the neck, but where the tongue is attached,
to gently lift and support.  The baby is rewarded with greater milk flow and
the mom's nipples are more comfortable during the feeding.  The reward and
repatterning of suckle motivates the baby to correct his technique.  Mom may
have to support the tongue in this way throughout several feedings, and
intermittantly after that.

When tongue motion is an issue, I usually have the mom get the baby to
finger-suck before latch to develop a coordinated pattern of suckle.  The
mom can gently stroke the baby's tongue to elicit movement.  Once a sucking
pattern is established, I have her remove the finger and immediately put the
baby to the breast.  It usually works right away, but may have to be
repeated at the next few feedings.

Some babies do not correct with the finger suck.  These are usually
brand-new newborns who, because of medications or birth trauma, are not
ready to even suck the finger.  Then we let them wait, and offer again when
the baby seems interested in feeding.

Barb Berges BS, RN, IBCLC
Rochester, New York

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