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Lactnetters,

Do any of you have cases of short tongues  and breastfeeding that you
could share?

 I am working with a mother whose 4 day old baby's tongue cannot extend
over the lower gum line.  There is no frenulum and the tongue tip can
reach the roof of the mouth when the baby's mouth is half open.  The chin
may also be slightly receding.  Baby can attach and suck best in the
straddle sit and in a prone position, however I have not observed regular
swallows  when he is sucking.  Suction is strong and negative suction
cheek dimples are frequent.  The jaw also seems to be doing more of a
biting action, probably in compensation.  It hurts mom to breastfeed and
there are suction blisters after just a few longer feeds.  Under the
areola and in the lower breast also hurt which I suspect is from
compression of the gums on the areola (This area of the areola is red).
There is no compression stripe after nursing on the nipple tip.   Baby
has been clamping some, but that is resolving with increased feeds and
relaxing of the oral hypertonia present the first days.  Baby was born 3
weeks early.

This mom was unable to breastfeed her first baby who was separated from
her for most of 5 days & received bottles early on.  She refused the
breast and only latched 3 times--- and every time was very painful.  Mom
did not have access to a good breastpump and hand expressed for 6 months.
 She wants this baby to learn to feed at the breast.  She and Father are
not sure, but think the first baby's tongue may have been short as well.
Both mother & father were breastfed, but do not know if their mothers had
pain.

For now mother is pumping her milk after limited breastfeeding practice
and finger-feeding baby to satiety with a p-syringe.  We are considering
an sns at breast since increasing the milk flow with a p-syringe at
breast seemed to reduce the pain for mother.  Also, mother said it hurts
more for her psychologically when baby is not fed at  breast  because of
her previous experience, including repeated mastitis.

The Breastfeeding Answer Book says to expect resolution in 4-6 weeks when
there is a short tongue.  This mom would be thrilled if that were all it
was going to take.  When I checked lactnet archives for short tongue
there were no cases discussed and one LC shared that breastfeeding was
not possible in the cases she has seen.  I don't want to offer invalid
hope.  I do want to hear your stories and outcomes for perspective and
possible treatment tips.

I would appreciate any sharing or perspectives on this that you can
offer as I support this mom and help her find a way to breastfeed that
meets their needs.

Thanks!

Natalie  Shenk BS IBCLC
private practice Findlay Ohio USA