Pam Price tells of an extremely frustrating case where Mom with hamburger
nipples and tongue-tied baby is discouraged by TWO MDs from having a
frenotomy because it is "not serious enough" and "baby will outgrow it."
Mom is now formula-feeding entirely.

Pam handled her end absolutely perfectly and ethically.  She did not tell
Mom *what* to do, but rather loaded her with info to then share with the
docs about frenotomies.  So Mom consulted three experts (including our
IBCLC) about a baby who could not nurse effectively, and the end result is
Mom is not nursing or expressing breastmilk at all.

This sort of stuff drives me absolutely nuts.  I'm just prickly enough today
that I'd be inclined to take off the kid gloves, and write a "follow-up
report" to both docs ... though I suppose in a saner (self-protective?)
moment I would just put the letter in my bottom drawer.

"I have spoken with Jane Doe, who tells me she has stopped breastfeeding and
breastmilk expression entirely, and is feeding her baby 100% formula.

"If abandoning BF is not a serious enough consequence to warrant the
clipping of a short frenulum -- one of the quickest, least-invasive
procedures a newborn can have -- then perhaps one of the other likely
outcomes is: the life-long health benefits afforded by lactation are
truncated, baby's jaw and mouth development are hindered, emerging teeth are
not afforded the hygiene that a free-ranging tongue can offer, and speech
development is hampered.  Heck, even "French kissing" will be a challenge
when the time comes.

"It has been my experience, working with nothing but breastfeeding dyads for
the past xx years, that a short-frenulumed baby does not ever outgrow the
condition.

"Indeed, mothers whose nipples are repeatedly and continuously shredded by
the desperate attempts of the baby to maintain continuous upward pressure
with a tethered tongue find that they must forego their dreams of
exclusively nursing their children.  Breastfeeding is the safe, healthy
biologic norm -- and as AAP and ILCA so clearly and strongly recommend -- it
is the manner of infant care all HCPs should encourage and facilitate for
all their patients and clients.

"I enclose for your review several articles exploring the negative impact of
tongue-tie on breastfeeding, the ease of remedy in frenotomy, and the
immediate improvement reported by moms and evident in the faces of now-sated
nursing babes.  I welcome your call to discuss any aspect of this case."


Liz Brooks, JD, IBCLC
Wyndmoor, PA, USA

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