For the miserable baby:
Have mom make sure she is not holding the baby's head at all during 
feeds or while latching.
Encourage mom to lay on her back and lay baby on her chest, allow baby 
to self attach and come off as often as she needs to.
Allow baby to take a one minute feeding if this is what she seems to want.
Good luck with the proton pump inhibitor, hope it helps this little one.

For the retrognathic baby:
Encourage mom to find a "grant pump".  Both major pump companies allow 
their rental depots to supply a limited number of free pumps a year.  
Since the year has just started, the depots should have grant months 
available.  Mom may have to pay for the kit, perhaps at cost.  Perhaps 
you could get her a kit from the hospital.  Make sure the kit and pump 
are the same brand, mixing causes dangerously high pressures!
Encourage mom to hang in there.  Babies with short jaws become good 
feeders at about 12 weeks of age.  This seems like forever for her now, 
but if she can borrow an effective pump, bottle feed expressed milk, and 
practice at the breast once or twice a day, things can come together 
with a little time.

For your friend:
Domperidone is cheapest from New Zealand and islands nearby.  Perhaps 
someone can give her a month's supply as a gift. ;-}

Kudos on doing the frenotomy!  Hopefully this mom will go rave to her 
pedi now, and he will be convinced to look into the recent literature.  
Let me know if you want a list of citations for him.

Catherine Watson Genna, IBCLC  NYC

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