Cindi,
Since we're working in the same community with the same doctors and other professionals, I thought I'd share my two recent cases.  The first mom had the most severely traumatized nipples I've ever seen.  She and all three of her other babies were tongue-tied. Other babies were weaned early.  Doctor refused to clip and she wouldn't hear about anything he didn't approve of.  I gave her all the info, pulled my hair after she left! and waited. I had one contact with her the next week.  Nothing else.  I thought for sure she had weaned but she called last week about returning some materials to me and said nipples healed, baby adjusted and grew, and now she is still nursing at 2.5 months with baby in the 90th percentile all around.  Relief for me that it worked out, but she thought I was nuts for even bringing up the clipping...apparently that whole experience confirmed my craziness or ignorance or both.

The other one is the bizarre case I told you about by phone recently.  I did suggest she have a breastfeeding-friendly OT evaluate as there were some other concerns also.  She found an OT who swore she was knowledgeable about breastfeeding.  The OT told her there was no way she could breastfeed this baby, she must bottle feed, clipping would not help, if she insisted on breastfeeding him she should do so for no more than 15 minutes each side every so often (don't remember what), etc.  Baby had never lost weight but had actually had very rapid gain due to a very abundant supply (this was the one where the doctor said she probably did not have enough  milk but the baby was just programmed to gain over an ounce a day...on what---air??).  Mom believed the OT was right, started giving a bottle after the prescribed amount of nursing, fell apart emotionally, got the clipping done, went back to nursing just fine, at least part-time.  I'm not exactly sure where they stand right now.

In the first case, I knew I could not push. I had to back off.  In the second case, I boldly told the mom I disagreed with the OT and exactly why.  I'm glad I did.  The lesson I learned was that we need to find a GOOD, breastfeeding-friendly OT locally. Let me know if you have a resource.  I had such regret over making that suggestion to her and have wondered if I would do in the future if faced with a baby who appears to need an OT eval.

Good luck.
Amy

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