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Lip Out Technique(II): uses in treatment

Lip Out Technique(II): uses in treatment

The Lip Out technique, developed by the pediatric physiotherapist and IBCLC and director of Grupo Aúpale, José García Morales, is a diagnostic and treatment tool for breast latch sealing during breastfeeding.

José García, trained in this technique in the LactApp Updates. This article summarizes the first part of the session.

The Lip Out, which we remind you, consists of removing the infant’s lower lip in order to observe the tongue and assess whether it is able to maintain the vacuum. It can be used in the following situations:

– Prefrenectomy
– Postphrenectomy
– In situations with a dysfunctional and/or disorganized sucking pattern.
– With the aim of improving the seal
– In conjunction with digital longitudinal stretching of the frenulum pre and/or post frenectomy
– Pain on latch and/or during feeding
– Sensory-motor dysfunction without short frenulum

The goal of treatment with the Lip Out technique is to enable the infant to make a grade 3 or grade 2 seal without clinical symptoms. To do so, the aim is to treat the functionality of the tongue with respect to sucking. It can be done during sucking, at the time of latch-on, it can be done with sucking at the breast (BLO) or with sucking on the finger (FLO).
In the case of finger sucking, the infant’s position will be supine, and in the case of breast sucking, it will be done in the cradle position, in this case it can be the mother herself who performs the technique, with or without the help of a third party.

LIP OUT
TREATMENT TABLE ACCORDING TO DIAGNOSIS

DEGREE OF COMPETENCE IN TONGUE SEALING TREATMENT TIME AND FREQUENCY
GRADE 0*

NO BLO1

BLO 1 if possible

If not possible, only do FLO

1 min in each breastfeed
More demanding FLO 1 min; 5-8 times a day
GRADO 1*

Presents BLO1

BLO 2 if possible

If not possible, do BLO 1

1 min in each breastfeed
More demanding FLO 1 min; 5-8 times a day
GRADO 2*
Presents BLO2
BLO 3 if possible

If not possible, do BLO 2

1 min in each breastfeed
More demanding FLO

Not always necessary

1 min; 5-8 times a day
GRADO 3*
Presenta BLO 3 o BLO 2 sin clínica
NO TREATMENT

BLO: Breast Lip Out
FLO: Finger Lip Out
* To know the grades, check this post
JL García Morales 2022

The Lip Out technique in the latch is a technique that can give good results but requires a great effort for the infant, that is why it is not recommended as a first choice technique for this case, only when other techniques to facilitate a good latch have not been successful. 

Reference:

García-Morales, J.L. (2022)

           “Lip Out. Physiotherapy in Breastfeeding”.

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