I have PTP.

Saw a baby today who has not been latching. 9 days old.  Baby was having a hard time flanging both the upper and lower lip at the same time.  If mom pulled down on the chin, baby would flange both lips but when he tried to latch to the breast his bottom lip would roll in.    When he rooted, his bottom lip did not flange.  At rest, the lip would turn in to the mouth. The chin wasn't really recessive, the chin itself seemed fine, it was the lower lip that was inverted (for lack of a better term).     

There was also a blister in the center of the top lip.  When mom bottlefed EBM, if she got one lip to flange, the other would tuck back in.  The top lip was very red while he fed.  He also leaked milk out of the corners of the mouth.  

This mom really wants to BF directly at the breast and had difficulty with the first child.  I was hoping this one would be easier for her, and I was at a complete loss of what to suggest (outside of maintain supply while I do more research!)  She is going to try a nipple shield again because she said that he did latch on that way a couple of times.  

Could it be poor lip tone?  What would she do to fix something like that?  I don't want to see trouble where there is none, but I also don't want to miss something that is a problem.  Any ideas?
Thank you!
Lisa Paul, IBCLC

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