What would you say about a baby who keeps her tongue on the roof of her mouth virtually all the time at rest?
The baby appears to have normal muscle tone, however the mother happened to tell me that the baby "literally spits her pacifier across the room" (note I have previously discouraged paci use) and that "she is very hard to keep on her back, she is trying to turn over already." this leads me to believe there are tone issues. The mother's nipples are very sore/ raw red, and pain that started at 10, came down to 8 after some minutes, and changed to 5 with fixing the latch. However 2 days later, still quite sore and traumatized. We have a plan which at this time involves nipple rest and expressing, and paced bottle feeding with some simple strategies to encourage tongue down. This is a mother who has been a bit reluctant about bf anyway, and I am surprised she is still working with me. She also had some slow weight gain, or actually baby did not gain for a couple days, and mom's supply seemed a bit low at first, not being able to express colostrum at all the first day, very scant the next day and milk slow to "come in". There were several things, as is usually the case, on the mother and the baby's side. I see no evidence of tongue tie to the best of my ability to assess this. Can any of you comment on the tongue situation and how to best improve that? Thanks.
 
Laurie Wheeler, IBCLC, MN, RN Mississippi, s.e. USA 
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