The longer that a baby feeds without having a necessary frenotomy the
longer she needs to re-train her tongue to do what it can do.

I had a client last summer who had been advised at her baby's birth that he
needed his frenulum clipped.  The ped said it was not necessary and it
wasn't done.  I was called when baby was 4 months old because mom was ready
to stop breastfeeding because her nipples were still sore.

It was one of those clear cases, attached almost at the tip.  Dad is a
physician and would not consider it unless the ped agreed.  He also asked
among his colleagues (anesthesiologists) and they agreed that the ped
should make the final decision.  So I had a long discussion with the ped,
who finally agreed to approve its being clipped by an ENT MD.

Because baby was 4 months old, the procedure was more painful and had more
bleeding.  He was uncomfortable feeding for a couple of days. Then it took
a couple of weeks of training, within which he gradually found more
flexibility in his tongue movements.

During the days that baby was uncomfortable and the weeks while baby was
learning to suckle properly, mother was in great doubt about having had the
procedure done.  I think that she was angry at me for advising it and for
getting the ped to agree. She wouldn't return my calls.

Then one day she called me to say that she was going to feed for a long
time because it didn't hurt and was so much more enjoyable now.  She was
grateful for my advocating for her and her baby.

So while baby learns to use his tongue properly, his mother will need a lot
of assurance that it was a good decision and an explanation of compensation
with an inflexible tongue.

Pat Gima, IBCLC
Milwaukee, Wisconsin


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