It sounds like this child is sliding the elevated posterior tongue back 
and forth against the nipple, which we've seen in our ultrasound scans 
of tongue-tied infants breastfeeding. Some keep doing it after 
treatment, particularly when treatment is delayed past 3 months of age 
or so (sucking skills get nicely myelinated by then!). It is very 
painful for most mothers. This mom is very brave to be still bf and to 
plan on tandem nursing.

Do you think the palatal ridge looks like a torus? Or is it just a 
prominent midline suture? If it's a torus, that could hurt the nipples.

At this point, I don't know if anything can help. Do you have a speech 
or occupational therapist in the area who are knowledgeable about 
sucking and breastfeeding? Exercises may have some impact at this stage, 
but it will probably take a very long time.

Catherine Watson Genna, BS, IBCLC  NYC

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