A 7 day-old in my practice had a frenotomy performed by ENT surgeon today.
(He told them this is the 50th one he has performed, so he's experienced.)
Mom has been maintaining breastfeeding despite very damaged nipples and
terrible pain. She did not like using pumps (there is a cultural issue) and
has hand expressed one or two feeds but has preferred to keep
breastfeeding. Her supply is bountiful but the baby as of today is 10%
below birthweight.

The parents reported to me that the MD told them the tongue-tie was not
very severe (the baby had a totally "forked tongue" -- the notch was quite
deep, so my impression was different than the MDs). He performed the
procedure in his office. There was excessive bleeding. At first he tried
silver nitrate to stem the bleeding. When that didn't work he used electric
cauterization. The mother said she nearly fainted. The baby's poor mouth
looks a fright -- the entire floor of the mouth is burned from the
cauterizing and the baby's top lip has a chemical burn from the silver
nitrate. The bleeding was such that the MD ordered a CBC to be drawn today.
(Results not back yet)

The good news is that this little baby can now extend the tongue and is
breastfeeding well. Mom's comfort level has improved dramatically, as well.
The mother had been afraid to nurse after the procedure because of the
bleeding. Of course, during the office visit with me this afternoon the
baby was almost swooning with enthusiasm to be back at the breast. I had
the baby suck my finger for a couple of minutes using the "charm hold"
(while Mom got herself ready to breastfeed) and had great results. The
tongue relaxed and moved all the way forward. The parents were very
concerned the baby would be in too much pain to breastfeed, but I pointed
out that the baby wouldn't be so happy breastfeeding if that was the case.
They "got it." :-)

I've never seen such bleeding following a frenotomy. From now on I won't
assure parents ahead of time that there won't be much bleeding...

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html