I have a client with a 9 week old baby. Baby was tongue tied and was clipped
before mom came and saw me...about 10 days old.   However, the baby was
still not latching after clipped.  I noticed that the baby was using
positive pressure or tongue thrusting. I instructed mom to get a finger
feeder and help retrain baby to suck correctly. I just revisited this baby
who has poor milk transfer at the breast. Mom is using a shield.  Baby
throws a fit if brought to the breast without it. Mom has wonderful
elongated nipples but still the baby is resistant to latch without shield.
Baby is not tongue thrusting but has a weak suck for a 9 week old. Mom has
been pumping after every 40 minute feed at the breast and then offers the
baby 3 ounces of milk via a bottle. Baby shows consistently loud slurping at
the bottle and arches backwards when the milk flows. I readjusted baby and
bottle with paced feedings and baby still slurpy but not so stressed.
Parents report baby chokes on occasion if medication or fluid gets shot back
in mouth.  Parents report that baby is stuffy all the time and that baby
gets milk up the nose. This baby has slow weight gain and I noticed an
obvious submusosal tongue tie.  I am sending this baby to a really proactive
doctor to rule out any other health issues as my gut is telling me that
something is not right.  I feel really bad for sending this family back for
more oral surgery but what are the options at this point? Can a baby have
other reasons for the symptoms presented?   Just needing some reassurance.
Thanks.

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