Please Help!
I saw a mom yesterday for difficulty with latch and painful nipples.  She was *very* reluctant to come in, because she "didn't plan to take the baby out before two weeks", and is now not very happy with me because I couldn't solve the problem.  (I guess I'm not very happy, either...)
Baby 4 days old, above BW.  Probably because mom has copious supply and good MER, and because she's also bottle feeding with ABM.
Mom's nipple very cracked across the center.  "Nipple", because she only attempts to nurse on the left - she had this same problem with baby #1, and since the L was less painful than the R, she nursed only on L with that baby, in pain, for 3 months (along with ABM) before giving it up.
This new baby, when offered my (gloved) finger, does not attempt to draw it in.  Will allow finger to be slipped in to mouth gradually, and will begin to suck, but does not cup with tongue.  Little tongue motion felt, certainly not the usual front-to-back peristaltic motion.  No seal achieved with tongue.  Gags easily as finger is advanced, but once finger at junction of hard/soft palate does not show any distress at that.
At the breast, baby will try to latch, will even suck a few sucks (swallows fine), but just can't stay on.  With a deep latch, mom has no pain, but that baby just can't hold that breast in her mouth.  I think the reason is the immobile tongue.  No better or worse at the seldom-used breast.
The baby is not classically "tongue-tied" - the first cm or so of the tongue is free, no heart shape, can get tip of tongue to gum ridge, but perhaps not over it.  However, my impression is that the majority of the tongue is just plain fused to the floor of the mouth and simply can't move much.  I don't see how any clipping would be possible - this is a tongue-wide, thick attachment, not a bit of thin membrane.
This mom is not going to pump ("I tried that once with my son, but I didn't like it, so I never used the pump again"), and is not adverse to using bottles, and isn't gonna maintain a supply and wait for the tongue to grow - she never intended to breastfeed for more than a few months anyway.  It's fix it now, or lose the chance.
Is there anything to be done?  Am I incorrect in believing that there is no way to free this tongue? TIA for the expert information I hope to be reading ASAP.
Willow, still in Detroit (Michigan, USA), still rainy