Ana;

It sounds like yeast to me. I doubt the labial frenulum is the cause of her discomfort at this point, if it was an issue why wasn't it bothering her until 4+ months of age?
The cracking at the base, the red dots, and the puffiness of the areola all point to yeast. Also, the fact that the APNO is causing relief shows that it certainly could be fungal in origin. If it were a bacterial infection, I think it would be more severe after three months without resolve/ treatment.
I suggest that you have baby treated as well, give hygiene precautions, and continue with the APNO.
Good luck!

Julia Augur IBCLC, RLC

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