Alison,
Thanks for the explanation of the mechanism of oral hypertonicity in
allergic infants.
        I was not saying that tongue retraction or tongue tie are
responsible for oral hypertonicity, this is usually neurological.  I was
talking about a biting/chewing suck.
        I also agree with you that tongue ties often result in a loose
suck and overactive jaw excursions.  This is expecially true in the
severest cases.  In less severe tongue-tie, flicking of the tongue
against the nipple with recoil is typical.  These kids tend to overuse
chewing motions to compensate for the relative inability to stabilize the
tongue.  I have seen this continue for some time (weeks) even after
frenotomy.
        I think the problem is that there is not yet a standard
vocabulary for subtle suck differences, leading to communication
difficulties.  Something else we as a profession need to hammer out.
--
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]