Erika,
That the bay could extend her tongue is no indication that the baby does not have a TT. IMO, function is a more efficient evaluation tool than visual assessment. With all due respect, I have had moms email me photos of their babies from all over the world who were told they were not TT by doctors and IBCLCs and indeed most were. One clue that a baby might well be TTd is a CST appt that improves things, but the treatment doesn't hold (although I do not understand her decision not to return when she had improvement). I suggest she return again and that if you are not confident with the assessment of a PTT, you get an opinion from a colleague who is. If that is ruled out, (or even ruled in) then I would be looking at mom's diet and baby's gut function. 


Jennifer Tow, IBCLC, France
Intuitive Parenting Network, LLC



Date:    Fri, 1 Jul 2011 16:26:42 -0600
From:    Erika Lance <[log in to unmask]>
Subject: sucking issue with a 10 week need help please

I have a client that saw me back when baby was about 2 weeks old. Infant had
characteristics of a tongue tie with no tie. Tongue came forward past the
gum line and can extend it well yet broke the suction throughout suck
assessment. Baby was not gaining well and mom had low supply.  Now, after I
have had her pump after every feed to increase milk supply she is making
about 20 ounces per day.  Baby is 10 weeks now and has gained 4 pounds in
the last 2 months. Mom called to say not much has changed with baby still
struggling at breast. Baby clicks at the breast with a slower flow. Both
sides have nipple wedging after baby eats. so mom has consistent achy
nipples. Baby has bottles in the evening of pumped breastmilk because mom
rather pump and not fight baby to feed at breast and mom reports the baby
breaks the suction often with bottle. Baby also fights and kicks and punches
when the milk slows down. Mom does pre and post weights after every feed and
baby transfers 1.5-2.5 ounces per feed. I am at a loss. Mom hates the
struggling. I am thinking it is a suck issue. Mom said she had one treatment
of cranial sacral treatment and reports that for a day breastfeeding was not
a struggle. Hasn't gone back. I wanted your thoughts or opinions on how to
help. I am frustrated and so is mom.

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