Leslie
I don't ever refer to a ped I do not think will clip based upon themother's experience as well as clinical assessment, otherwise many ofthem would never be clipped. One thing you can certainly do is referbaby for CST/chiro and be sure mom is doing stretching exercises wbaby's tongue. In all honestly, though, TT babies take a lot of timeunless they are clipped w/in a week or so, b/c you have to navigate momthrough an unsupportive system. Also, have you contacted the ped to seeif s/he will advocate for mom w/ surgeon or contacted the surgeonyourself. I would have a difficult time trusting a surgeon to clip farenough, though who did not clip a baby who needs clipping, even if heis convinced to give it a go. This mom may have to travel, but sheneeds to get herself to someone who knows what he is doing. I oftenlecture on "An Integrated Approach to Solving Feeding Problems" and Iencourage every LC to create a supportive network in her own community.It may take a lot of time initially, but will save time and heartachein the long run.


Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network, LLC
 


Date:    Sun, 17 Jan 2010 16:20:39 -0500
From:    Leslie Cree <[log in to unmask]>
Subject: advice for a mom w/tongue-tied infant

Hello Wise Mentors! I am hoping you can help... I have been working with a mom 
since Dec. 28, whose baby I referred for 2nd opinion for my dx of posterior #4 
tongue-tie. First pediatrician disagreed w/assessment,  at 2nd opinion visit 
ped. concurred and referred mom to a surgeon. We had hoped to have the tongue 
clipped and begin working on helping baby re-learn to latch deeply and feed w/o 
causing mom pain. The surgeon declined to perform any procedure as he "didn't 
think it was enough of an issue" (mom's report of Dr.s comments, I wasn't 
present). Mom has compressed nipples, lipstick shape, constant pain with every 
feed. Baby is gaining adequately (confirmed at dr.s weight chex) but mom is 
miserable. We've worked on positioning, latch, approach, increasing skin-to skin 
and feeding frequency to keep baby calm, pumping when mom is in too much pain to 
feed. Baby has had only mom's milk. Thrush has been ruled out, and miraculously 
mom has had no broken skin, scabs, or cracks in her nipples. Is there anything 
else I can suggest to her while I research a surgeon to offer a 2nd opinion? 
Ped. is also now evaluating baby for allergies because baby is gassy and has 
"loud belly sounds." Mom is to bring baby for a check up on 20 January, along 
with a stool sample. I haven't been in private practice very long, and I am 
feeling swamped and frustrated. 
Thank you kindly,
Leslie Cree IBCLC
Mechanicsburg, PA (Harrisburg area)



 
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