I also agree with Rachel Myr that if the breast fills the oral cavity,
there is less difficulty for a tongue-tied baby.  This is because the
most severe deficit with a tongue tie is in tongue elevation.  If the
baby can easily get a big mouthful of breast, then the tongue does not
need to elevate as much to push milk out of it.  Imagine an equilateral
triangle, with one point in the baby's mouth.  The more you push the
triange in the mouth, the less the tongue tip has to lift to compress
the triange.

Babies are also smart, and they come up with compensatory strategies to
move milk, even if their tongues are restricted.  Some kids use the
upper lip to press milk from the breast, those are the ones with huge
sucking blisters, who are moving the breast in and out of the mouth as
they suck, or who sweep the upper lip over the breast, often while using
the upper gum the same way.  Mom often reports pain and bruising from
that upper gum.
Other babies use excessive jaw compression, or bite the milk out.  This
is inefficient, tiring, and painful for mom.  These are the kids who
compress the nipple, and mom says they are chewing on her.  These babies
often have 'fatigue' (enhanced physiologic) tremors of the tongue or
mandible that increase as the feeding progresses.
Still others use a rotary movement of the mandible, scraping milk out of
the breast with their mandible as it retracts.  I can go on, but I'm
sure you all get the picture.

So, just because a baby manages to breastfeed with a tongue tie does not
mean that the tongue tie is not an issue.  Okay, stepping off the
soapbox now!
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

             ***********************************************

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(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html