>>My question is:  how likely is it that a *receding chin* would cause
breastfeeding problems?  I was always led to believe that babies have
receding chins on purpose, so they can get up close to the breast.  Now, I
HAVE heard one LC talk about jaws that don't line up, so to speak, so that
the jaws don't effectively compress the sinuses.  How much of a connection is
there between receding chins and jaw compression issues?  Does anyone have
anything to say about assessing jaw alignment?  <<

I am *not* the expert of experts here, but I do want to add my observations
to the discussion.  Yes-- to some degree, all babies have a somewhat receding
chin. But then, there are the *really* receding chins, and they ARE a
problem! Most characteristic is that mom will be using normal, good latch and
positioning technique, and while the top lip will plant in the right place on
the breast, the bottom jaw/lip will repeatedly slide up to the base of the
nipple. Often times, you can look at the parents and note that at least ONE
of them has a noticeable receding jaw as an adult.  Such an exaggerated
receding jawline in a baby simply makes L-O trickier, and requires
experimentation to find a way to counteract the problem.

Often, the "football" hold gives the baby a better approach angle to the
breast. Sometimes I will make minute adjustments--- baby forward more, baby
pulled more on his back, whatever it takes to optimize the angle so that the
jaw stays planted where I want it to land.  It is also quite often necessary
for mom to shape her breast into a firm sandwich and maintain her hold so
that the breast does not easily slip from baby's mouth.  The good news is
that, as they get older, this becomes less of an issue and diligence can
relax. It is getting started in the early days that is hard!

The ability to compress the sinuses is less often a major issue, but I have
definitely seen that, too.  Baby needs extra help to be sure that he gets on
as deeply as possible, because jaw alignment may mean that his tongue does
not extend to the proper place to adequately compress sinuses against the
palate, resulting in possible poor intake.  Again, time and growth are the
best cure after positioning modifications.

I hope this is helpful.

-Lisa Marasco, BA, IBCLC
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