I just had a patient with a similar problem.  I saw her and her baby one
week after birth.  The mother had sore nipples, and the baby had an attached
frenulum.  I explained the problem concerning it and breastfeeding, and went
on to relate to her that her pediatrician (who has 8 children, all of whom
bf for 3-4 years), would not clip it, despite being given all the
information I had on this subject, including the article from JHL. I told
the patient that the ENT and oral surgeon in our town would clip the
frenulum with no hesitation.  The patient stated that she and her husband
wanted it clipped.  She went to the pediatrician about it, and he would not
clip the frenulum as predicted. She did not do anything for one month.
Breastfeeding continued, with increasing supplementation.  The patient and
her husband were having dinner with another physician, who is an OB/GYN, and
he told her that where he is from, the OBs clip all attached frenulums at
birth (he is from Ohio).  He did clip the frenulum the next day. This is
something that may need to be considered, since pediatricians are reluctant
to clip frenulums.  Maybe OBs are less hesitant?

By the way, the patient stopped breastfeeding, but would she if the
pediatrician agreed to clip the baby's frenulum?  She is very upset about
weaning.  This is her second baby, and she did not bf it as long as the
first baby.
Sharon Gollman, RN, BSN, IBCLC

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