Hello. I am Meg Wright, Physician Assistant & LLLL.  I am counselling a
woman whose 10 day old son has a thick frenulum.  I.E.  I have not seen
him move tongue over lower lip. and when he cries the tongue appears
forked.  I am precluded from any real physical exam as my contact with
this woman is LLL not as a P.A.  When she called describing the
situation, I suggested she get it clipped and explained that it is very
low risk.  (I personally have clipped two and one did not even bleed; the
other only very slightly.)  Meanwhile, Mom has very sore nipples and
doesn't feel like he's "on right."  Today I rented her a pump because she
is pumping alot and feeding with bottle because of pain at nipple and his
difficulty latching on.  Of course I discussed nipple confusion and
described cup feed/dropper feed, etc.  The reason for her hesitancy to
get him clipped is because she talked to a speech pathology professor who
told her that if a frenulum is clipped "too far", it would cause the
child to never be able to utter a certain 2 or 3 sounds in the English
language.  I tried to point out that some of the risk -benefit ratio may
be being skewed.  Later I asked if the prof . had ever seen a kid who'd
been clipped too far and gently wondered aloud that this clipping too far
risk may be a a very rare complication.  I have already discussed
difficulty of long term pumping , nipple confusion etc. with her.

Either the baby's frenulum will stretch or she may come around to getting
it clipped if I can give her some documentation and or opinions of other
speech pathologists.  She seems committed to breastMILK, but not to
breastFEEDING--as her fear is the (improbable?) clip/language
complication.  Any help will be appreciated.

Thank you.  Meg Wright, PA-C, LLLL