Your baby's lips don't need to flange or take a 'special k' shape when breastfeeding + how baby swallows milk
Your baby's lips shouldn't be working or even visible during breastfeeding
The sensitivity of your baby's lips help her find her way to your nipple.
But lips don't need to work during breastfeeding, and are never visible in the gestalt method. As long as your little one doesn't have a cleft that extends to the upper lip or some other congenital abnormality, the shape of your baby's lips will be normal. But of course, normal is a highly diverse condition in human beings.
This is not something we let many other adults do with our babies, because we know the intimacy of it, the precious physicality of caressing kisses showered over that silky scalp, with a baby's scalp's distinct yummy scent, the slurpy, playful kisses and blowing of air and noisy mm-mm-mm-mm kisses being planted all over the little one's face and neck and chest, the baby's utter trust in your safety and protective love. Inhaling our baby's sweet milky scent, the eye contact and the smiles and the warm caress. Baby, I delight in you. Baby, your mother loves you. May you know this forever in your bones!. Every baby needs a dose of this cuddly physical love from at least one special adult, day after night, night after day, throughout his or her babyhood and childhood. It's a particular wound, not to have had a loving adult or more delight in you as a baby and child*. *It is essential to our little one's psychological resilience, to have that body memory: I am adored.
Babies' brains have a well-formed neural body map laid out in a strip of grey matter that runs between the ears over the top of the head. Touching the middle of baby's lip provides the strongest possible activation to that strip of brain tissue. Sensory-motor pathways for the tongue are also mapped over a large part of the newborn's brain.
You can find out about the myth of upper lip-tie in babies here.
The swallow
In a swallow, baby's soft palate lifts from the base of the tongue (or the posterior tongue) to allow the bolus of milk to slide under it down into the oesophagus. You can find out about the palate here and the posterior tongue here. The tear-drop shaped uvula diverts your milk into two streams, down into the little channels which track the milk around the epiglottis and around the opening to the vocal cords and airway.
The epiglottis protects the larynx (or voice-box). The epiglottis doesn't close down like a toilet lid, but is a soft and moving plate of tissue which diverts milk away from the larynx and trachea. The milk flow separates to flow either side of the epiglottis. Some milk is aspirated intermittently, but this is not a problem for most healthy babies.
The semi-prone (baby lying somewhat tummy down with the mother in a semi-reclined position) of the gestalt approach helps protect the baby's airway by having the milk fall forward with gravity - but you don't have to worry about this and if your baby isn't feeding in this position and all is going well, that's fine too. If you have a baby with a floppy airway, the gestalt method is ideal.
At the beginning of a feed, you might hear a rhythmic soft 'k, k, k, k' with the suck-swallow-suck-swallow which is jaw drop - k - jaw drop - k. I find it easier to listen for the 'k' if we are wanting to know if there is swallowing, although we can also watch for the rhythmic movement of the tempero-mandibular joint.
Babies have no air in their mouths when sucking and swallowing. Professor Donna Geddes and her team found this in their ultrasound studies, and Dr Mills has confirmed it by MRI. Professor Geddes' team has also taken intermittent ultrasound assessments of breastfeeding babies' tummies over the years and have also not found large amounts of air.