Ann,
I find that babies with recessed chins almost always suck in their 
bottom lip and we have to gently pull it out after latch on. When they 
close their mouths, the two lips don't meet, rather the bottom lip goes 
under the top and if you look, it even appears to be sucked in 
sometimes. You are right that a baby with a recessed chin needs a 
different latch on than normal babies. I have found the football or 
clutch works well to get that chin smooshed in nicely and the nose 
pointing out.

I believe Barbara Wilson-Clay has correlated tongue tie with recessed 
chins and I certainly see a lot of these babies having what looks like a 
short tongue or a short frenulum. I do not see many babies with recessed 
chins sticking their tongue out and down past the bottom lip. Often they 
can get them to the gum line and it looks fairly normal but when they 
can't remove milk well and never stick out their tongue past the lips, I 
really wonder.

Is this baby what we would call an "arching" baby? Does he attempt to 
latch and then stiffen his back and arch away from the breast? Does he 
hold his head up already? One mom told me yesterday that her baby 
stiffens his legs out totally straight when she bottle feeds him and he 
holds his head up at 8 days.

Pumping: two ounces isn't that bad. What kind of pump, hopefully a 
hospital grade? And are her flanges big enough? I said this on one of my 
last postings but if mom did not get enough breast stimulation in the 
first days, she may not make a full milk supply but 2 ounces isn't that 
bad.

Lastly, when he was on the breast during your consult, what were the 
test weights? I would want to know how much he can remove from the 
breast during a feeding. He may have latching issues but can he remove 
milk?

Kathy Eng, BSW, IBCLC

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