I always assess the mouth well when I am working with a baby the mother/baby nurses have concerns with. My own grandson had a posterior short tight frenulum.  My daughter and her husband refused to listen to my concerns about it as he was having good output, and yellow bowel movements by day 5. He would also sleep and not really care to nurse but she had him on the breast constantly because of that.  She even knew her supply was not as plentiful as it had been with the first, despite me saying, he doesn't remove it as well, that is why....the output had my daughter and her husband feeling he was fine.  He was 38 weeks, a home birth that was perfect,  but he acted younger.  His latch was NOT 100% perfect and when I would try to explain to them and show them the frenulum, it was so unimpressive to them as he had good output.  But I knew what would happen....bili hit 20 by day 7 (after I said GET HIM INTO TO THE PED NOW! Or we will be in the hospital tomorrow) and he didn't gain ANY weight at all.  He stopped losing but he never gained anything.  Then and only then did they put their tails between their legs and understand.

So many frenulums are not obvious but can play such a major role in milk removal and production! I am teaching our other CLCs and IBCLCs to PLEASE assess the mouth. Some Docs are not understanding it, we know have a little information sheet the parents can give to them.  Other Peds helped me write it and it was approved by my Director.

And today a mom wrote an email thanking 2 of us and her Ped....she was about to give up but her Ped got her an appt to get it assessed and taken care of....so 3 weeks after birth she is a happy mom!


Pamela A. Hendrix BA, RN, IBCLC
Lactation Consultant
Family Birthplace
Memorial Hosptial West
Lactation help line: 954-844-9908
All other calls: 954-844-6950
Portable cell: 954-844-3337


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