>An LC or nurse should have a list of people in the area who will do >frenulotomies to whom pts. can be referred. (Dream on - as if there were >huge numbers of them in most places....!) That's what we do with other >resources, right? > >Cathy Bargar RN IBCLC Ithaca NY Here's the way I "found" my MD who clips frenula for my clients. The baby obviously needed to have the frenotomy done in order to continue breastfeeding. The ped disagreed but did agree to have a consult with an ENT physician. The mom went to the ENT and he said that he didn't see it as enough of a problem to put the baby through "general anesthesia" for the procedure. I sent him the material from the JHL on the subject. He read it (!) and called the mom with an agreement to do the "simple" frenotomy, which he had never done before. (He had thought she was asking for a frenulectomy.) Her nipple-pain relief was immediate and she wept as she thanked him. "He has never fed this well!" I sent a follow-up report to him telling about the improvement in feeding and growth of the baby--and thanking him for assisting this mom and baby. That was 5 years ago and this doctor has clipped numerous babies' frenula since then. Sometimes he tells the mom that her baby's frenulum doesn't look overly tight, but that other babies have improved in their ability to suckle well after the procedure. He advises her to be ready to feed the baby and that there will be little or no bleeding. I've seen him do the procedure several times, because the mom is often scared and asks me to go with her. He has a pleasant, calm demeanor. In these 5 years, every baby whose frenulum was clipped has gone on to feed well (and thrive) without trauma to mom's nipples. Depending on the age of the baby, sometimes the resolution isn't instant, and there needs to be some suck training--the older the baby, the more set is the suck pattern. I am now encountering a few peds who will clip the frenulum and I have one OB who will do it as a second opinion consult. I would like to see more OBs trained to do it so that the procedure could be done early. Sadly, many peds still refuse to approve the procedure and the mothers wean the babies to abm (or pump for a while) either because of the pain or because of poor weight gain. These parents don't have the courage to get a second opinion and will agree to the procedure only if their ped agrees. But, to end on a happier note, I am thrilled to have this ENT on my team. Pat Gima, IBCLC Milwaukee, Wisconsin *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html