Saw a mom here at the hospital per request of the mom who had been seen by
three nurses who had tried to help and were unable to latch the baby on without
pain for the mom.
I entered the room and identified myself as the lactation consultant NURSE and
evaluated the situation. Mom had great breasts, good positioning, baby opened
mouth WIDE then latched on and mom was in pain. Checking baby's mouth out I had
seen that there was a thin short frenulum near the tip which caused the tongue
to form a heart shape. I attempted various positions to see if I could latch
baby on without pain, but mom was very uncomfortable. I explained to the
parents that even though some babies can latch on with a tight frenulum, it
seemed to me that the baby should be evaluated by a physician, as he may need to
have it clipped. I described the procedure and gave the name of the MD that I
usually refer to. (I have never met the MD, but as he was the only one who did
them when Ifirst started here, and he has been very good about seeing patients I
refer quickly, I gave them the number.)
Well - today I got a FURIOUS call from the Pediatrician. I am not to refer his
patients but am to tell him what I recommend and he will decide what needs to be
done. Frenulums, he informed me, were made of granular tissue and will
stretch so that this surgery is unnecessary.
I explained that I went to the patients at the request of the nurses who had
been unable to help the patient, and that I identified myself as the nurse-LC
and gave my evaluation and recommendation as such.
What next? I'm ready to tell this MD that I just won't see any of his patients
- I can't imagine seeing a patient, identifyig the problem, then trying to
contact the Ped via telephone, beeper, etc. and being unable to explain to the
patients what I see.
Am so angry right now that I'm writing to cool off - writing to you my friends
rather than writing to the MD something I will be sorry about in the future.
Thanks for being there!
Jeanette Panchula, BA-SW, RN, IBCLC
Puerto Rico
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