I have some interesting cases to present to y'all if I can grab some
uninterrupted time tonight.  Meanwhile, here's a short one:  I saw a baby
of a primiparous woman who at 2 weeks is still not latching on. (Mother was
expressing breastmilk and feeding by bottle after long attempts to latch on
at each breastfeeding.) He is biting and I could not get him to extrude his
tongue past his lower gum using the various tricks I have learned.  He also
has a high palate just behind the upper gums but not in the back of the
mouth at the junction of the hard and soft palate, which is low and flat.
He does not have the classic tongue-tied look (heart shaped tongue, where
the tongue is clearly being restrained by the frenulum) but he must be on
the continuum of short frenulum.  He loses his latch over and over.   We
were successful at getting him latched using the pinch hold for inverted
nipples (although his mother has lovely nipples, a bit tight underlying the
nipple but not inverted) and he managed to finish the feeding very well at
that point, even when I subsequently let go.  I therefore recommended the
mom use the hold to assist baby getting on, and if necessary staying on,
the breast, and to consider frenulectomy if that doesn't seem to be
working.

LactNetters have said the frenulectomy is low-trauma and high-benefit, with
immediate results.  Would you reserve it for extreme tongue-tie or
recommend it in any case where a mom and baby are struggling?

Arly Helm

[log in to unmask] (Arly Helm, LC)