05/27/2017
Important.
Lip Appearance During Overuse
I’ve written previously about the importance of recognizing compensations when trying to improve infant feeding quality.
Instead of “we need to get the baby’s mouth bigger”, we should ask “Why is the baby keeping his mouth so small?”
Instead of “you need to flip those lips out”, we should ask “why is the baby pursing her lips in so tightly?”
Instead of “lip blisters are totally normal”, we should ask “are blisters anywhere else considered to be normal?”
I would argue that the #1 compensation that is made by a tongue-tied baby is overuse of the lips. If the tongue cannot hold the seal, then the baby cannot generate a vacuum. Without that vacuum, there’s no feeding. So what does the tongue-tied baby do? They use their lips.
So what’s the big deal about using the lips? Well, lots. First, the baby cannot use the lips and maintain a wide latch at the same time. To achieve a compensatory seal with the lips, the baby turns the ni**le into a straw. If the baby is holding the latch up front with the lips, that means that there’s no contact between the tongue and breast. Since we already have several studies demonstrating that mid-tongue elevation of the breast to the palate is the key to generating a normal vacuum, the baby who uses their lips must generate the vacuum in a different manner: jaw muscles. That’s why they bite down. That’s why they fatigue so quickly and fall asleep. That’s why mom can have residual milk despite feeding the baby at the breast.
Lip blisters can be pretty dramatic. Chafing and chapping are also frequently seen and are the precursor to blisters. One more sign that’s important to recognize: two-tone lips (see picture). If the baby pops off the breast and the inside portion of the lips are pale, it’s a good indication that the baby is overusing the lips. In chronic cases, the lips remain pale even between feedings. There’s often a thin rim of pink around the pale lips.
Keep your eyes out for these signs. Question your lactation consultants and primary doctors if you’re told it’s normal. It’s not.