Hello Friends,
I have been working with the most amazing woman through four months of painful feeding.  I wrote to the list about her before.  She finally went to our main frenotomy dentist for a "consult" even though I did not think that baby's tongue was tied or his upper lip (the pain during feeds is across from baby's top lip)  The doctor said that the baby has a tt and a short tongue and snipped 4 times, according to the father, including the labial frenulum.  Since then things have gotten worse.  Feedings are more painful than ever and baby keeps losing the nipple during feeds and for a short time milk was coming out of his nose.  I suggested tongue exercises to the mom, like sticking her own tongue out and to the sides... while baby mimics. I suggested nursing on her back to help babies tongue come down and out but the mom says that that was the most painful.  My thought was that he needs to learn to use his tongue in a way that he never has. (I was following advice from the recent thread about the 21 month old who stopped nursing post frenotomy.)

He is now two weeks past frenotomy. He is getting better at lifting and moving his tongue but feeding is still painful.  The doctor told her on the phone that it is a good sign, that something has moved, and to come back.  The family was more than a bit traumatized the first time and would like to avoid another clipping.

They came here last week. The baby goes on beautifully but quickly pulls his head back so that he is on the nipple.  The nipple never looks squished but the area across from his upper lip is bruised looking (this has been the problem all along).  I tried checking his mouth and found that he gagged before I got to the junction of his soft and hard palate, making me think that he is not used to having anything, including mom's nipple that far back in his mouth.  I taught her exercises to hopefully desensitize his gag reflex but haven't heard how that is working.

The mom will do anything to make this work.  She'll nurse even if it hurts but she would really like to enjoy it.  Meanwhile the baby has more than doubled his birth weight at 4 months old and clearly enjoys nursing, or whatever he is doing.  Does anyone have any ideas what will help this baby and mother?

Thank you for your help,
Chayn Fogelman IBCLC Israel
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