A former client referred a friend of hers that delivered at another
facility.  The former client's baby had a tongue tie and I had given her
information and the list of local docs that correct tongue tie (only one
doctor on the list until a few months ago, now we have 2 doctors a
pediatrician and an ENT) The former client ended up changing pediatricians
because her original ped was not supportive and because she was so impressed
when she went to the pediatrician on the referral list (yes he was the only
doctor on the list at the time...but he really was the only one that
preformed frenotomies in our area) The new client comes in with a very
tongue tie 7 day old baby.  I give her the same information regarding tongue
tie.  She tells me that her baby's doctor, a family medicine doctor, does
clip frenulums if necessary and he told her that her baby was tongue tied
but not enough to warrant correcting, not significant enough.

I asked her what she thought of that. Of course she thought she needed
another opinion so she came me.  Her baby was very frustrated at the breast,
he would attempt to latch and then get too frustrated and finally mom would
quickly pump with the Avent Isis while dad calmed a screaming baby.  When he
did latch he would fall asleep fast and within minutes of appearing to be
satisfied he would be frantic again.  Her nipples were blistered and a chunk
missing here and there from the scabs that had come off.  Needless to say,
feedings were not going well.  Since the baby's doctor didn't feel that it
was serious enough to treat, I gave her the information and suggested that
she call him back and discuss it with him.  I explained that some tongue
ties are not a problem, but to consider that if the baby is not gaining well
(hers was but only because she was feeding him or working to feed him non
stop),not able to latch deeply, or nurse until full, (like he was since he
was wearing out so fast even the few times he did latch deep) and mom was
extremely uncomfortable when he does latch and nurse, that it would be worth
considering.   I explained to her that is the criteria that we go by when
recommending a frenotomy.  I also had her try a nipple shield to assist with
getting the baby to nurse, protect her nipple and assist the baby in keeping
the nipple is his mouth without wearing out.  In the office she seemed very
comfortable with this and baby nursed very well with shield.

So she goes back to the family doctor who refers her to a different ENT than
the one on our list, (and this is the reason that the ENT he referred her to
is not on our list)  The ENT agreed with the family doctor, he felt that the
tight frenulum was not severe enough to warrant frenotomy, because he will
grow out of it.

UGH!!!!!   So after hearing that, the mom decided that she was in too much
pain and the baby was too frustrated, she is not even going to pump, she's
just going to formula feed.  I told her to call me if she decides anything
different or if later she wishes to relactate.

Another one lost because of ignorance...
Pam Price IBCLC, CBE
Lactation Services Coordinator
Women's Health
Trident Health System
9330 Medical Plaza Drive
Charleston, S.C. 29406
(843) 824-5013 office
(843) 728-9640 pager

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