Cherie Rice asks: " Do any of you have any ideas for a hands-on teaching strategy illustrating the difference between the breast and bottle in a baby's mouth?" Subject: Breast, Bottle Sucking Patterns Teaching Strategies "Hello, Fellow Lactnetters! I will be presenting a 30 minute session on "Sucking Patterns, Breast vs Bottle" at a Lactation Conference next week. My session will be geared for new IBCLCs, WIC counselors, nurses, etc.; not advanced practice LCs." I do need to make a comment on this topic. I was well trained to read all sorts of x-rays in my previous profession. One of the times I heard Michael Woolridge talk he showed the old x-ray movies -- cineroentgenography -- of babies sucking at the breast and the bottle. He wanted us to see the mouth, jaw, and tongue action of the breastfed baby at the breast. The bottle feeders had a barium solution in the bottle. The breastfeeders had the breast coated with a radioopaque cream that showed the outline of the breast. When the baby was latched on deeply at breast and when the bottle was placed in the baby's mouth so that the lips are on the broader base (and not on the narrow part of the nipple teat) as the babies were in these moving x-rays, there was no difference in tongue movement between the two types of feeding. I even went up to Michael afterward to discuss that there were no differences and he agreed. If we go back a few decades to when the concept of bottle-feeding differences was brought into the arena of breastfeeding, bottle feeding was accused of causing different actions of the tongue -- one being the possibility of stopping a fast flow from a large nipple opening. Although this might occur, it might not in the majority of bottler feeders. I see all kinds of funny tongue movements some babies are born with (apart from tongues with the back of the tongue raised and the tip pulled back) -- sticking their tongues way out, pointing them, pushing their tongues against their little fists or fingers. These actions may linger longer in some. If these babies don't latch well, or by their tongue actions disturb their feeding at the breast to a great degree (and I have seen this), then in the past babies like this may have been bottle fed. If the mother still had difficulty breastfeeding her baby, and then used a bottle, then sought breastfeeding help, I can see how someone might have concluded that the bottle feeding had caused the tongue actions. I see that babies can have different tongue habits and that when the milk begins to flow well and the suck swallow breathe is rhythmic, that the habits can change to a good tongue action in most babies. When a baby isn't latching deeply on the breast and the nipple doesn't extend back far into the mouth along the tongue I imagine that friction can occur that can injure the skin of the nipple. When the areola/nipple is deep in the mouth and the tongue rises up to press into it there is no friction rubbing the tip of the nipple. If the nipple is not deep into the mouth and therefore not far back along the tongue, then when the back of the tongue rises it can slip on the nipple tip as it rises and meets the palate (instead of the nipple that should be back there). It can also cause a wedge shape to the nipple. This same action could be reinforced with bottle feeding or a pacifier or even by sucking on a finger if none of them are back far enough in the baby's mouth. Therefore I think it is difficult to talk about the differences between breast and bottle feeding. We can talk about how to bottle feed well -- with the baby's mouth open well, the bottle nipple deep in the baby's mouth, and the lips flanged on the wider part of the bottle nipple. We really don't always know what is happening inside the baby's mouth. We can have the baby suck on a finger to get a feel for any irregular tongue positions or actions and discover that some are more out of the realm of normal than the other. Some babies who have more complex tongue problems don't feed well at breast or bottle. Mardrey Swenson DC, LLLL, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html