I have seen a mother with a baby who latches on but not effectively 
(mouth angle 90-100 degree, shallow).
Mother has no pain but the baby nibbles at the breast without sucking 
effectively (very negligible intake).

The mother is probably not managing to stimulate a wide gap and to seems 
not able to find the movements necessary to help the wide latch.
She also has rather large nipples.

I have tried to make an assessment of the sucking ability of the baby, 
and all seemed well (good grooving, correct wave movement), a part from 
the fact that the tip of the tongue did not elevate (protruded beyond 
the lower gum, but did not reach, not even tried to reach, the upper gum 
when stimulated nor when the baby was crying).

The one time we did manage to have the baby latched properly, she 
breastfed beautifully for a couple of minutes with a good swallowing 
rhythm and measured milk intake.
Then she got off the breast and that was the end.

There are, in this case, many factors that may be contributing to the 
poor latching, but I am wondering if the fact that the tongue did not 
elevate has a clinical meaning, or if it could be irrelevant.

I have not managed to find out if the baby occasionally do elevate the 
tongue tip or not. I have asked that to the mother, explaining that if 
the baby does not do that, it could be sign of a problem (which could 
explain their difficulty), but the mother never answered directly.

Hope you can share your experience on tongue tip not elevating.
Could it contribute to poor mouth opening?
I am convinced enough that the problem is in latching, rather than in 
suckling.

Thank you for any suggestion.

Micaela
LLL Leader, Italy

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