I have a baby that is 3 weeks old and has started to vomit what mom is calling large amounts during the feeding and/or right after the feeding.  Baby also tends to choke on the milk before it comes up (during the feeding) and she also will cough/gag between feedings while she is lying down.  She had “normal” spit up the first couple of weeks.  She is doing well and growing well otherwise.  I know there are multiple possibilities. I am suspecting a posterior tongue tie.  Baby had a short frenulum-close to tip of tongue at birth.  It was released before discharge and latch improved.  Although, both me and the pediatrician felt it was not fully released. When we evaluated the tongue after the frenulectomy we both suspected there may be a PTT.  The doctor who did the frenulectomy was not comfortable doing anything further.  We do not have a doctor that revises PTT. Baby is now on Zantac for reflux.  Mom wants to try Zantac before she comes to me for further evaluation. I have not seen baby since she was 3 days old.  Based on what I have learned about PTT, I feel the spitting up large amounts, especially during the feeding, is due to baby not being able to swallow correctly due to her restricted tongue—which causes her to choke and gag, which then brings up the milk. Although, why do these problems tend to show up between 2 and 3 weeks after birth?  I hope you are able to follow this post!  Sometimes it is hard to explain things in writing.  Just curious about your thoughts on PTT and these types of symptoms in babies.  Thanks!

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