I have seen this sort of tongue tie as well, and it can actually be more
difficult for breastfeeding than the simple thin membrane attached to
the front of the tongue.  I've had 2 parents have frenuloplasty (the
more involved surgery) with great results, from agonizing pain to
comfortable, effective breastfeeding over several days to a week.
Another 3 or 4 parents did not have surgery done for the baby, and with
time, the breastfeeding improved.  It took one of these infants 6 weeks
to be able to sustain a latch and then a few more weeks to transition to
exclusive direct bf, and another few took longer for the breastfeeding
to be comfortable for mom, though baby could chew enough milk out of the
breast to grow.  There are many others who were unable to hang on until
things improved, and weaned.
Now I tell parents of infants with these restricted tongues without an
obvious frenulum that the baby is likely to be able to bf with time if
they maintain a good milk supply and bottle feed with breastfeeding-like
pacing and cueing (like Dee Kassing's method).  If the parents can
handle it, at least some fingerfeeding and some circular massage on the
anterior tongue seems to assist as well.
Finally, my favorite pediatric surgeon/IBCLC has learned that one can
clip the tissue at the base of the tongue in many of these cases, and
open up a diamond-shaped area that allows more tongue movement in all
directions.  This can be done with a topical anesthetic, and is far less
invasive than a frenuloplasty.
Catherine Watson Genna, IBCLC   NYC

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