Hi, y'all--
        On the thread of nipple confusion (which I prefer to call suck
confusion):  what do we call the babies who hunch/bunch their tongues up
in back?  (Where the tongue ends up where it does after saying the
English word "people".  English has two separately formed "L" sounds--the
clear "L" as in "leap" and the dark or obscure "L" as in people. Stuff
like this is the outcome of a degree in linguistics, sorry!!)  Tongue tip
is either behind lower gum or on top of it, but the tongue is not flat
and curled around mom's nipple "like a hot dog in a bun".  Some babies
have longer-than-seemingly-necessary tongues and these babies are prone
to doing this, but it's not limited to long-tongued babies.
        Some of these babies are **born** with that kind of suck, before
any extra-uterine experience at all; others develop it after artificial
teat use; others after sucking on another object:  folds of clothing or
blankets, thumbs, other available body parts, mother's chin, etc.  This
is what I consider suck confusion and work to get the baby to drop and
extend his tongue on my finger, preferably while introducing liquid for
him to swallow; transitioning immediately to mother's breast for the
reward of her yummy, sweet milk to motivate/reinforce his efforts.
        This sort of suck confusion is very common in the babies I see.
In my experience, this tongue bunching is the difficulty most of the time
when suck confusion is present.   Many of the moms I see out of the
hospital setting are clueless about the names of any meds they may have
had during labor/delivery, and I have been unable to track causes for
this, other than it happens.
        I'm not referring to babies who don't suck well and are
unorganized at  breast (that's another post!), but the ones who seem to
know what to do, only they really don't.
        I loved Dr. Jack's idea of case documentation via Lactnet!  And
I'd appreciate your insights about why this happens to some babies.
(Other babies I see could probably get milk from a bedpost, they are so
focused and motivated at feeding time!)
        Karen Zeretzke, MEd, IBCLC
        Baton Rouge, Louisiana