In my experience it is not enough to see the tongue come forward over
the lower gum.  You have to lift the tongue up (with a gloved finger) to
see if there is a frenulum present.  If the tongue cannot "lift"
appropriately, the baby still can't "hold on" to the breast, and will
pinch to keep it in his mouth.  Often the palate will also feel
strange...either very flat or extremely arched, because the tongue
hasn't been able to help form it correctly.

Kathy Leeper, MD, IBCLC

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