Cheryl,
One thing jumps out at me here: this baby is miserable with his mother's
normal milk flow, and he uses a sliding motion of his tongue rather than
a peristaltic one.  Feeding seems like a lot of work for him, and he
seems uncomfortable and has difficulty staying on the breast, or comes
off voluntarily.

I've seen this constellation in infants who have posterior tongue ties.
Not at the front of the mouth where they affect the cupping and
elevation of the anterior tongue, but farther back where they mainly
affect the grooving of the mid tongue, which helps stabilize the breast
in the mouth and holds a bolus of milk for controlled swallowing.

The ultimate answer if this is the case is to find someone to evaluate
and treat him if necessary.  If the baby organizes sucking bursts poorly
(has to let go of the breast to take a breathing break), this is
probably indicated.

Some things that might help along with frenotomy, or instead if the
parents or doctor disagree, is to do some exercises to increase grooving
of the tongue (pacifier tug of war with a cyllindrical pacifier,
fingerfeeding, sweeping the tongue with a finger, etc).
--

Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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