Dorothy,
When there is no visible frenulum to perform a frenotomy, a frenuloplasty
is the procedure used to release a tongue-tie.  The surgeon makes a
horizontal incision at the attachment of the tongue to the floor of the
mouth, and sews it up vertically.  One of the infants in my practice had
this procedure under general anesthesia at age 2.5 or 3 mos, and was able
to breastfeed for the first time a week after the surgery.  Maternal pain
resolved as his tongue function improved over the next 2 weeks, and he
went on to bf exclusively.
        His mom had to see several physicians before finding one who had
been educated by a mother who dragged in her grandmother, mother and
daughter to the consult...  The mom had not been bf because it "killed"
the grandmother when she tried, the great-grandmother reported that the
grandmother had been 'clipped' in the hospital nursery and breastfed
fine.  The doctor performed a frenotomy on the infant daughter, and has
been a wonderful resource for LC's here ever since.  Keep talking, folks,
it sinks in eventually.
--
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]