Many thanks to those who posted replies to my request on Dec 13.  The suggestions were very helpful and mom was receptive to most.  To follow up:  two weeks later, mom still has sore nipples (blisters now) but still reluctant to stop BF and give expressed milk via alternative feedings...despite my encouragement.  Mom on mupirocin for damaged nipples and nifedipine for continued vasospasm.  Mom never tried nipple shield.
Baby still chomps and still cannot lift tongue to top of mouth so she was sent back to ENT who did the original posterior frenotomy.  ENT clipped the tongue again, said that the frenotomy site had scarred over, limiting movement.  Baby is doing CST with some improvement.  Baby's weight is fine, she gets supplemented via bottle with either EBM or formula after some feedings.
I suggested for mom to run her finger under the tongue frequently to prevent the open area from healing upon itself again.  Mom is doing pacifier pull exercises and I will meet w/her tomorrow to teach her how to use a finger feeder.
My questions:  
How often should mom do pacifier pull exercises?  
Can someone describe the best way to finger feed this baby to help the tongue move better?
If this is not successful, should this baby get a frenectomy?  Does anyone in the CT-NY area do them without anesthesia?
Any other ideas?
Thanks so much, sisters,
Annie Brown, FNP, IBCLC
Greenwich, CT

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