Hi! Have an interesting case. Mom called me about 6 weeks ago. Her baby was 4 months old. States she had been having nipple pain since beginning nursing! Nipples were red, especially at the tips.No broken areas of the skin or blisters. Mom held the baby towards her. Attachment was pretty good. Although the linguinal fenulum was not anteriorly attached, the movement of the tongue seemed limited...could bring it to gumline but not over lips. Could not lift it to the roof of mouth or move it side to side. I suggested that we have it evaluated by a Ped ENT, but she did not want any surgical(intrusive, as she called it) intervention. So, we began a series of treatments: 1. Since she had been on antibiotics postpartum and she described her pain as "burning", we treated she & the baby for 2 weeks with miconazole for mom, nystatin for baby and then 3 days of Gentian Violet .5% BID. No relief. 2. It was suggested that perhaps his grip on the breast was tight. Mom found a craniosacral therapy and got treatments for baby. No relief  3. Mom saw a speech therapist who concurred that the frenulum was indeed tight and needed clipped. Mom found an ENT who clipped the tongue. But, the mothers states that her nipples look the same and she has the same pain. Any suggestions? Do we need to do any exercises for the tongue? It seems that the baby has been compensating for the tight frenulum and tends to bunch the tongue up in the back. Am I crazy? Mother is disparing that she will ever be pain free. She feels caught between not wanting to nurse any more and her original desire of nursing until the baby wanted to wean. She is very much into attachment parenting so this is very distressing for her. Any suggestins would be very much appreciated.
Carol L'Esperance RN, MSN, IBCLC

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