SKILLS & STRATEGIES

Suck Training and Lip Toning Strategies

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SUMMARY:

Suck training can help teach a baby the correct tongue position for effective breastfeeding. To transfer milk from the breast, a baby’s tongue must be down on the bottom of the mouth and extend over the lower gum line in order to create a seal and suction on the breast. These are all gentle activities that can be done a few times a day to help your baby.

Equipment Needed:

• Hands
• Breast pump
• Breast milk storage container or 5ml syringe with cap

Steps:

Here are some basic movements that are generally recommended.

Tug of War- Tongue Movement

• When the baby shows feeding cues, place them in your lap at a 45 degree angle. Support the baby’s head in your non-dominant hand.
• Insert a clean pointer finger into the baby’s mouth, pad side up so you are touching the top of the mouth, or the palate.
• Use the pad side of your finger to stroke from the front of the palate toward the back of the palate until the baby starts to cup your finger with their tongue to suckle.
• With gentle pressure, use the back of your finger to push down on the back of the baby’s tongue, and to push the tongue toward the front of the mouth. Your goal is to encourage the baby to extend beyond the lower gum line.
• You should feel a strong, rhythmic suckling on your finger (not chomping from baby’s gums). Check that the baby’s lips are flanged outward as they suckle. Let the baby enjoy suckling your finger for up to 1 to 2 minutes.

Lip Toning & Massage

• Lips – Start with your finger directly under the nose and stroke to the corner of the mouth – Start again under the nose and massage to the other corner of the mouth, then rub back and forth along the bottom lip (repeat 3 times)
• Cheeks – Start with your finger at the corner of the nose and then massage in a half circle right next to the lips – then use the same pattern but go back to the middle of the cheeks – then massage from the corner of the nose around the back of the cheek. (Repeat on the other cheek). Think of this as drawing smiling lines on your little one’s face in wider and wider
• Cheeks – Start with both your thumb and first fingers at the back of the cheeks- where the jaw comes together and bring your fingers forward (making fishy face lips) Repeat 3 times.
• Cheeks – Gently insert clean index finger inside the baby’s cheek. Use your thumb of the same hand to slowly massage the tissue for 30-60 seconds. Repeat on the other side.

Now, remove your finger and latch the baby to the breast.

Follow Up:

In some cases, babies may struggle with how to position the tongue correctly and may not be able to transfer milk well even with basic suck training. This can result in poor weight gain, increased fussiness, and sore nipples. Talk to your healthcare provider and lactation professional for more help.

Resources:

Riordan, Jan & Wambach, Karen “Breastfeeding and Human Lactation,” 4th edition, Jones & Bartlett, 2010

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