Ann, 

Everything I ever needed to know, I learned from my childbirth instructor
(who is a retired LLL Leader) -- including where to take my son for a quick
and correct frenulum clip with no hassles.  It turns out I had to go
further than I might have on my own, so it was good that she knew.  Have you
asked local LLL Leaders if they've had mothers find success with this issue
anywhere?  It might be a good place to start.  Another idea might be to ask
local maternity wards if they remember "old" doctors who used to do rounds
every morning and clip the tight frenula as a matter of course (that's how
the pediatrician who clipped my son established himself as a
frenotomy-friendly guy, by doing "courtesy clips" ages ago before it was a
liability issue -- or an "issue" at all).  Midwives may also have some ideas
-- midwife lore tells of one long fingernail on a midwife's hand, used for
detaching tight frenula in the old days.  Who knows?

This may be a simplistic answer to your other question about the baby's
curled tongue -- but when the mother bottle-feeds, does she ensure the
baby's tongue is down and forward under the bottle nipple, as it needs to be
for the breast?  I've seen success with mothers letting their babies suck on
their finger for a few seconds, while mother gently but firmly presses down
on the tongue and draws her finger out to show baby where his tongue needs
to be while feeding -- then latching him onto the breast immediately.
Again, I know this is for plain old nipple confusion (and for what it's
worth -- the Avent bottle was a far cry from those fast-flow hospital
nipples, and was a useful tool in encouraging my 6-day old little girl back
to my breast after being fed bottles, because we could really control where
her tongue was and the flow was slower -- she had to work much harder to
feed from it) but I thought I'd at least offer the ideas that popped into my
head as I read your post.  

I'm of course very interested to read the "advanced" answers that will deal
with anatomical difficulties and suck dysfunction.  I just feel guilty
reading all the time and not contributing much -- so I contribute when I
think I might have some scrap of something useful! :)

--Diana in NY (LLL Leader, IBCLC to be, hopefully 2009)

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