Dear friends,

I have discussed this with some LN sisters privately but would like to throw
it out to the group as well.  I have a client that had been BOF/ABM for 4+
months when she decided to go back to breast.  She stated that buying ABM
made her physically ill.  At the first visit the baby would not even
consider going to the breast; he was a challenging and frantic baby.  Mom
has gotten a partial supply in with the use of Domperidone, herbs, hospital
grade double pumping and now has been able to get baby back to breast with
an SNS.

She is a very determined and intelligent mom she has perused the internet
and has had contact with some of the great LC's.  She believes that her big
problem now is TT.  The baby was so upset at the first visit that I was
unable to check well for a tight frenulum; he did however, have a high
palate.  Yesterday I was able to catch a brief glimpse at a minimally tight
frenulum; he is unable to lateralize or place tip of tongue at the roof of
the mouth. I was unable to do a suck eval but he has been seen by a PT and
she says that baby is capable of placing a cupped tongue over the bottom
gum.  Mom's nipples are tender but nothing close to what I would call
damaged.

The issue now is that mom is unable to find anyone willing to clip the
frenulum.  The one ped that does an excellent job will not clip after NB
days/weeks.  This babe is now 6 months old.  I know of one ENT that does
TT's but he always uses a Z-plasty and I doubt that would be necessary; this
doesn't appear that tight. The only things that concern me are the lack of
milk and the fact that the tongue does not move freely.

Do any of you know of a Ped/ENT/Orthodontist here or near Oklahoma City?

Thanks for your help and have a happy Thanksgiving.

Royce 

What you permit, you promote	
	
Royce Anderson
RN, IBCLC, RLC, CD (DONA) 	

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