A "prominent" labial frenulum is a possibility.  I had 2 babies with this
problem in the fall. The babies were taking in a lot of air and were
"snapping" off and on, and one mother had very sore nipples. The babies
were unable to flange their upper lips.  Upon examination I could see the
prominent frenulum between the lip and the gum, and in one baby the ridge
continued across the gum line and into the hard palate (the mom with sore
nipples). The other had the ridge on the gum but not on the palate.

The mother of one baby had had a large space between her front teeth, and
had the frenulum surgically corrected when she was a child.  The other
baby's maternal aunt had the same, and had her surgery as a young adult,
followed by braces to reposition the teeth.

The resolution is not simple like the tight lingual frenulum is. Both
mothers have decided against correcting the problem, as the HCPs were not
open to addressing it.  They have found that feeding in the side hold with
baby mostly upright, helps with feedings. One mother may limit the extent
of her breastfeeding because this is her third child and she is on the go a
lot, needing to feed in public, which she did with the first two with ease.

I'll send a post from Dianne Weissenger on laser surgery as described in a
JHL article.  I don't know which issue. It is interesting that I have seen
so few of these cases, and yet I saw 2 within a week.

I'd love to learn more on this structural problem, and cases of resolution
in the infant stage. As it is now, no one is interested in correcting it
until it interferes with the teeth.

I wonder if Brian Palmer has addressed this.

Pat Gima, IBCLC
Milwaukee, Wisconsin
_______________________________
X-Sender: [log in to unmask]
Date: Thu, 17 Dec 1998 18:48:45 -0500
To: [log in to unmask]
From: [log in to unmask] (Diane Wiessinger)
Subject: labial frenum

Pat -

You know I have an article in JHL on this.  It's the only one I've seen.
Baby failed to gain well until labial was lasered (no bleeding with laser).
It was a bit equivocal because baby started solids soon after.  But mom
feels it tipped the balance.  And her first nursing after the laser was
dramatically different for both of them.  Baby's eyes opened wide "as if he
couldn't believe what he was doing."  He was 4 plus months old (as I
recall, without looking), and his improper sucking patterns were pretty
well established.  But she no longer had to monitor his position.  Mom was
never sore.  Even when they had rampant thrush (his was the worst I've ever
seen).  The only effect for them was limited access to sinuses.

Diane

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