In my small practice, I don't see that many tongue-ties.  This one was
borderline, but seemed to "fail" Alison Hazelbaker's assessment tool, at
which I don't consider myself at all skilled.  At birth, he'd had trouble
latching on.  They came to me at 3 weeks with persistent mildly sore and
mildly distorted nipples, trouble latching, the mom's insistence that the
baby wasn't swallowing often - hadn't swallowed rhythmically in the past 3
days - and her belief that he was growing so well only because she was
pumping for relief bottles to save her from exhaustion.

Perceptive mom.  In his first visit here, he didn't trigger a let-down until
the very end, in a position the mother hit upon (though he sucked down a
couple ounces total in dribs and drabs).  We made some latch-on
improvements, talked about clipping, and she went home using the new
position.

Swallowing frequency increased, one nipple stopped being sore, the days
weren't quite so tedious, everything was moving in the right direction but
not fast enough.  She had his tongue clipped at 5 weeks.  The next day he
nursed to satiety in 10 minutes... and the day after that, everything was as
bad as ever.  No let-downs, sore nipples, frustrated baby and mother.  I
told her I thought her bad news was probably good news, and sure enough, as
his tongue healed her nipples improved for good, his feeds shortened, he
started throwing up (I assume because he's still adjusting to needing less
nursing), and she even saw him "practice" losing the latch and drawing her
in again, something he'd never been able to do before.

An unremarkable story, but one more plug for clipping, and clipping early...
and for not assuming that a well-positioned baby is swallowing!

Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

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