The midtongue elevation you are describing is usually another symptom of
tongue-tie.  Sometimes the tongue attachment is too close to the gum
ridge rather than being too short, this causes the tongue tip to appear
free, but the tongue to be restricted further back.  Which either pushes
the nipple out of the mouth when the baby tries to extend the tongue and
the midtongue rises, preventing latch; or prevents the tongue from
extending and pulling the nipple back deeply into the mouth, leaving the
nipple compressed as you are seeing here.
        If it is not severe enough to warrant a frenotomy or frenuloplasty, the
following may help:
Extend baby's head when approaching the breast (tip it back) so the
lower lip comes to breast first.  Start out with the lower lip on the
areola about a half inch away from the nipple.  When baby opens his
mouth (he will open wide, because the nipple is far away) have mom pull
him in quickly.  This usually makes for a decent latch.  Have mom lean
back so baby is nursing "uphill", as these babies often gulp and choke.

        As for the breastpumps, tell the mother that the type you can hold in
one hand have tiny motors that need to work for a long time to get one
suck:release cycle.  The better pumps have large motors, that allow the
pump to cycle 40 or more times a minute.  More like baby, less stress on
the nipple because it is only pulled for a fraction of a second, instead
of several minutes at a time.  I recommend Ameda Egnell or Medela pumps,
either the rental models or the personal double pumps (Purely Yours or
Pump in Style) depending on how long the mother is going to be seperated
from the baby.  The greater the seperation, the greater the need for the
hospital grade pump.
--
Catherine Watson Genna, IBCLC  New YoX-Mozilla-Status: [log in to unmask]

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html