I saw a mum a few weeks ago.  She called me when baby was 5 months old because the baby hadn't gained since the 3 month check up. Breastfeeding had become very painful in the last 2 months. 

Once I saw mother and babe I realized that baby had a type 3/4 tongue tie. 

Mother had had a huge supply with strong letdown. Baby was charting at 90th percentile for weight for the first 3 months but then when mothers supply dropped from lack of proper stimulation (baby wasn't actually latching, just drinking letdown) baby stopped gaining. 

When baby tried to start latching at 3 months she was unable to take mothers long nipples in her mouth deep enough without gagging. 

Nipples were just being crushed against the hard palate.  Baby also had a high arched palate which is commonly seen with tongue tie. 

Family opted not to get tie clipped at this point and mother has chosen to pump and bottlefeed. 

Tania Archbold BSc IBCLC LLLC
www.mothersnectar.ca

On 2011-04-21, at 14:58, "Judith L. Gutowski" <[log in to unmask]> wrote:

> HI Ladies,
> 
> 
> 
> I have a question for you all. I have a mother with an unusual combination
> of problems that seems to be working right now, but I am concerned about the
> long term outcome. Since it is such an unusual case I thought I would ask if
> anyone has had a similar case. Mom has given permission to post.
> 
> The infant is 9 days old and gained 8 oz between days 2 and 4 and gained
> another 13 oz between days 4 and 9. He feeds 13-14 times a day for 10
> minutes. So unbelievably he is doing fine right now. He does have a severe
> tongue-tie, short, inelastic and attached at the tip of the tongue and the
> top edge of the alveolar ridge. Hazelbaker score for appearance was 2 and
> for function was 4.  
> 
> Mom has very large on long nipples. The left side is worse and he only can
> accommodate the actual nipple into his mouth, He sucks on it like a straw.
> On the right side he can get on a little deeper and have a wide latch. Mom
> can pump 4 oz from both sides right now in under 10 minutes. The milk is
> basically running into his mouth and he is swallowing as if it were a bottle
> feeding. 
> 
> 
> 
> 
> 
> The pediatrician I work for clips tongues in our office and advised clipping
> prior to her visit with me. I also gave all of the background information
> about clipping tongues. Father has a tongue-tie and suffers from apnea and
> snoring, though never put it together as relating to tongue tie. Mother is
> reluctant to have the baby's tongue clipped. I told her I honestly have
> never seen these 3 circumstances combined and I don't know what the long
> term outcome would be. I have seen milk supply decrease when it becomes
> endocrine driven and then baby's weight falters with tongue-tie alone. I
> have had babies who were bottle fed breast milk until they could latch
> deeply enough to get milk from the breast. The oversupply and overactive
> let-down have compensated for both of these problems so far, but who knows
> what happens next. 
> 
> 
> 
> I would appreciate your thoughts and I told mom I would copy her on your
> replies if any were given. 
> 
> 
> 
> Thanks in advance for sharing your experiences. 
> 
> 
> 
> 
> 
> Judy
> 
> Judith L. Gutowski, BA, IBCLC, RLC
> 
> 135 McGrath Lane
> 
> P Box 1
> 
> Hannastown, PA 15635-0001
> 
> Cell Phone 724-331-6607
> 
> Fax 724-837-0129
> 
> 
> 
> 
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