Are your baby’s lips appearing “dry and blistered”? It can leave parents concerned on if it is just normal infant appearance or something deeper. These blisters could be suckling blisters, also known as lip blisters, friction blisters, or suck callouses. Infant lips are fragile in the first few weeks of life, but a persistent appearance is not normal. While this may not always be the case, seeing this appearance may be a red flag and a reason to dig deeper into what is going on in the mouth.

Sucking Reflex and Tension

We previously had a blog about body tension and sucking reflexes and how the whole body is used during a feed. To briefly recap, we learn to suck while still in utero, some documented as early as 14 weeks. Sucking at this stage is uncoordinated and these reflexes are strong in some and weak in others. Suck blisters can be at the top or bottom lip, all over, or more centered. This appearance suggests that a baby is holding on and feeding on a breast or bottle with their lips and not creating a proper seal using all oral functions properly.

Blisters are compensations manifested. The blisters/calluses do not usually hurt the baby. While feeding, moms may feel a gumming or biting sensation. Usually, it is the lip muscle (orbicularis oris) used to close the lips, that is overused. Meaning that the weight of feeding is not distributed evenly. There may be a few reasons for this:

Shallow latch

A common reason and one of the easiest to improve is a shallow latch. A deep, asymmetric latch helps the breast to sit back further so the tongue, mouth, cheeks, and lips can do their jobs effectively. A deep latch can decrease nipple pain and extract milk in a shorter amount of time.

Prematurity

Babies born before 38 weeks will have all the oral necessities with underdeveloped fat pads. Without fat pads in the mouth, babies compensate by using alternative muscles. These infants also are more sleepy and feeding may be a challenge. During the feed, the coordination of suck-swallow-breathe pattern is slower and weaker. Again, understanding how the whole body is used to feed, will help to understand how to achieve a successful feed.

Oral Restriction

In our mouth frenum is located in 7 areas, tongue, lip, and buccal. When the frenulum is short or tight is causes the area to be restricted from fully working in the capacity that normally. Restrictions can be caused by one or all of the areas mentioned.

HOW TO IMPROVE FEEDS AND RID BLISTERS

Improve positioning

Work with a professional to improve body tension and tightness. This can be through a lactation professional with this trained skill set or a qualified bodyworker.
Work on latch

Release the fascia (commonly known as tongue tie release)

It is important that if any of these situations apply to you and your family, it is addressed sooner than later. The muscles are what direct the growth in our jaw and face. If we have restrictions in the movement of our oral muscles, our bones are told to grow irregularly. This may be seen as the bones in the palate growing upward instead of wide. This then causes the jaw to appear narrow, rather than wide. Eventually, as the child grows older, we see a need for increased orthodontia work to fix crowded teeth or compromised airway development.

Babies are smart and will do whatever they need to hold onto the nipple, either breast or bottle. If you notice these blisters, either alone or in addition to pain while feeding, it may be a good idea to schedule an appointment with an International Board Certified Lactation Consultant (IBCLC) for a feeding assessment. Some IBCLCs are well versed and had additional training in oral restrictions and tethered oral tissues.