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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 21 Apr 2005 21:57:14 -0400
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Much posterior tongue humping is due to tongue tie. Donna Ramsay's 
ultrasound research demonstrated that this is the movement pattern that 
is seen in tongue tied infants, and it resolved by 2 weeks after 
frenotomy in all but one of her dozen infants studied.

A significant proportion of tongue tied infants have an easier time 
latching when the breast is soft. Once the milk supply increases and the 
breast is firmer, many can no longer latch, and are given bottles out of 
desperation. Babies are savvy, they figure out quickly what works to get 
food, and some will not bother with that frustrating breast when they 
have an alternative.

I know that the idea that bottles change tongue movements to defend 
against flow is commonly held, and while this is possible, I've not seen 
any evidence. I mostly find in my practice that the biggest issue in 
switching back and forth from breast to bottle is maintaining a good 
gape - a nice wide open mouth.  When infants are taught to gape well for 
either bottle or breast, they generally move back and forth more 
readily, in my experience.

I've been able to help babies who were bottle fed for several months to 
learn to breastfeed, and it wasn't even hard in most cases. It's much 
harder to get babies who seem convinced that the breast does not work to 
try again.

One interesting study was done in rats by Blass, et al.  I posted about 
it years ago. It's item # 038818 in the archives. Date 10/14/97, title 
Re: nipple confusion studies.
Catherine Watson Genna, IBCLC  NYC

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