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Subject:
From:
Melissa Lactation <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 22 Mar 2013 07:50:03 -0400
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PTP:
I've been working with a mom for over a month now.  First time mom with a
drug free vaginal delivery.  This was a planned homebirth wich transferred
to the hospital  Initially, the baby was 1ounce less than birthweight at 2
months old.  Baby was sleeping 8-9hours at night and using a pacifier
often.  Mother's nipples were sore and already had one bought of mastitis
symptoms.  When I observed baby at the breast, there was a great deal of
arching and not being able to make a seal, baby even struggled with a
bottle.  I showed the mother the short posterior frenulum and suggested
many things (waking every 3 hours, pumping, no pacifier, STS, etc)
including having the tongue clipped.  Mother's chiropractor suggested that
the tongue was fine, so declined to address this.  Now, a month later, the
baby is gaining well with both breast and bottle feeding. She still has
sore nipples with some struggles of getting the baby latched. She decided
to go to the ENT to have the tongue clipped.  According to her, the doctor
said that he could not get it 'to release'.  He said it was too tight and
offered to perform the procedures under general anesthesia.  The baby also
has a short labial frenulum and they were going to clip it also.
Can someone explain to me why the ENT couldn't clip the tongue?  Is it
because the baby is older and more active?  Do you have ANY suggestions for
this mother?  She is balking at the idea of general anesthesia (I probably
would too).  I have a local dentist who will do it by laser, but it is
expensive.  I am hesitant to send her there for concern that he wouldn't be
able to perform the procedure also.  Is it possible/probable that this
mother can just continue to focus on latching and overcome thesee short
frenulums?  I have discerned that much of this dyad's problems is mother is
not reading her babies cues and has been leaving the baby to work part time
since very early on.  I think that focusing on the latch and specifics of
baby care has been difficult for her.  She has already admitted to
ingnoring his cues and letting him fuss in the crib because he was just
being manipulative.  She understands how that has led to many of these
problems.
This was my first official consult in private practice, I hope it gets a
little bit easier from her.
Gratefully,
Frustated in SC
Melissa Senf, RNC, IBCLC

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