Judy, I wonder what else is going on? I'm thinking a breathing issue 
affecting ability to feed, especially as you have dealt with other issues. 
The "different" tongue- tie and the history you gave set me on this line of 
thought. If breathing difficulty is part of this equation, I suspect it may 
get worse, as the child has to feed, but feeding and swallowing stresses 
what ever is structurally or functionally wrong.

A baby I saw -  by the time I saw him - had progressed to breathing 
difficulties that worried me more than the feeding.  I wrote the referral 
report. A surgical team was able to help him, but there hasn't been a 
diagnosis.  Some of these babies with multiple oro-pharyngeal challenges are 
unique.  (This little one is now a gorgeous toddler.)

I'm going off Lactnet today or tomorrow as I'm leaving for Melbourne in a 
day and a half. Any replies, please contact me privately.

Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Brisbane, QLD

Judy LeVan Fram wrote

The baby was "only" 2 weeks early, and was frank breech, but her entire
system "looks" like a baby born much earlier. Even past due date, her 
ability to
feed was still severely compromised. Even after frenotomy ( which I
agonized  over making a recommendation since it was SO far back, and baby so
"affected"  somehow) baby only went from moving 0.2 oz to 0.4 oz at the one
feeding I  observed.  Many bottlefeeds take 45-60 minutes. ( Faster flows 
cause
more leaking, gagging, and shutdown) Mom confirmed her behavior is  similar
throughout the daily cycle. Even on the bottle, as of a week ago when I  saw
them at their first CST session ( watched a new CST practitioner for an
hour  since the amazing one I worked with for seven years moved away....), 
her
SSB was  "broken", milk transfer slow and choppy, and she still gets into
crying jags or  shuts down when undereating or overwhelmed. ( Not that I 
blame
her.) Even after  the frenotomy the tongue movement is limited as her
posterior neck and  shoulder region remains so tight she can barely open her
mouth and latches  shallowly with a shield and not at all without. 

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