Angela writes:

"My son is 7 months old, and has had a shallow latch since birth.  I have 
worked with his latch and nursed in every position that I know to correct and 
improve his latch.  He self-attached within an hour after birth and seemed to 
be doing very well.  By day three I noticed that he had a difficult time flanging 
his upper lip no matter what I did.  He would clamp on my nipple and cause 
compression stripes.  I have also dealt with Raynaud's since I had my first 
child seven years ago, which became very intense with this nursling. We have 
dealt with yeast off and on his entire life, and nursing him has never been 
comfortable. 

One of the red flags for me that suggest a tight frenulum is recurrent yeast (often presenting with Raynaud's). 
Many moms will say exactly that "nursing has never been comfortable". 

"I stumbled upon Dr. Brian Palmers presentation regarding labial frenums and a 
couple of old Le Leche League articles and thought I had found my answer.  
My son has a very thick, prominent labial frenum.  I spoke with our family Dr. 
and he had never heard of the labial frenum causing breastfeeding problems, 
and was reluctant to clip himself.  He ended up calling Dr. Palmer who quickly 
returned our phone call.  I spoke with a few of the Dr.'s and nurses at the 
hospital where I work, and they have never heard of the labial frenum being a 
problem, and felt that a frenectomy would not be needed. My Dr. ended up 
sending us to an oral surgeon.  We were finally able to meet with the surgeon 
yesterday.  I explained to the surgeon that I work with breastfeeding dyads 
and why I felt that this was my sons problem.  He told me that labial frenums 
do not affect breastfeeding (in his experience).  He also said that if I thought 
that my son was having pain, or that I really felt that it affected his feeding, 
he would perform a frenectomy."

I wonder how much experience this oral surgeon has with mothers who are currently breastfeeding when he sees
their children? Still, the fact that he is willing to do it anyway is wonderful--he clearly is open-minded enough to 
look at function rather than only structure. 

"I would love to gain some wisdom from any of you who have dealt with this 
situation before.  At this point I have an appointment in two weeks to have 
the frenectomy, but I don't want to push the issue if I am sincerely wrong. "

Well, I have had a number of clients whose babies had tight labial frenula and where clipping improved the situation.
I have seen other moms where their older children weaned prematurely due to pain moms had while feeding and 
observed very poor dental spacing and very tight labial frenula. I had one mom a couple of years ago who would not 
clip b/c her ped said there was no possibility that it would make a difference. Mom continued to nurse, with discomfort 
and I wonder what his top teeth look like today!

One thing I would caution you, though--I wonder if there is only a tight labial frenulum--I have definitely seen kids with 
only this one but usually the lingual frenulum is a tight posterior as well. 



 Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC

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