I worked with a case recently that was slightly different than I have ever
seen.
The baby was 2 month before I was referred to. The baby always had fdg
problems and mom has pumped her milk to give the baby and keep up her supply.
At 3 weeks the baby required cataract surg. Once that was resolved the fdg
issue came back to the forefront. After delivery mom was told the baby was
tongue-tied but the pedi did not agree, said it would stretch!
On my exam the baby tried very hard to latch but could not maintain and became
very frustrated. When she did suck it was weak. Exam of her mouth, the tongue
came over the left gum line but to the right of center the tongue was heart
shaped from the short frenulum. Dad told me he was tongue-tied and clipped at
birth and his sister who needed it clipped twice. This baby also had
difficulty with a bottle, tending to slide it to the left.
I found a wonderful ENT who saw this baby and not found the problem with the
tongue but also  a labial frenum. He  did the procedure under general because
the tongue was thick adhessions which he used a laser and then clipped the
top.
The baby is improving on fdgs both at breast and bottles. I asked the ENT if
there was any connection of the cataracts and the adhessions under the tongue.
He did not think so.
When I see short frenulums I always asked the parents. It's amazing how many
have the history.
Ann Perry RN IBCLC
Boston, MASS   USA