What we did before recognizing tongue-tie as a cause for many sucking 
problems and while waiting for the medical community to start treating them:
-optimize positioning and latch (we still do this)
-tried 'suck exercises' to see if we can help the baby strengthen the tongue
-fingerfed to help baby develop negative pressure sucking
-used supplementers to give baby milk flow with lower sucking pressures
-used pumping and alternative feeding if needed to feed the baby
-gave moms lots of emotional support
-hoped that as the baby's mouth grew, mom's pain would improve

Many dyads did manage to make breastfeeding work with all of the above. 
It often took several months, was very work intensive, and there was a 
high drop-out rate. Feedings were often prolonged, and mothers often 
struggled with milk production over time.

If mom doesn't want to give up, encourage her to keep working if she 
can't access treatment.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 2/13/2011 2:46 PM, Angela Hartfelder wrote:
> If I may, I would like to expand on your question of what to do with tongue tie when local resources are limited. What did the wise ones do to help these babies most between the time the medical culture decided tongue tie didn't exist, and the now slowly occurring realization by the medical culture that it does. (I'm still doubtful that the majority acknowledge its existence, much less the need for treatment.) Like you, I see these poor dyads and without resources to get them clipped, I can only give them the tools to limp along. What did we do best to help them before we had the still expanding availability to get the TT clipped? How do you help them when you know the problem and the solution, but have no way to apply the solution?
>
> On to you other questions- "is MediHoney a prescription-only item?"
>
> It can be obtained over the counter. If you have a good compounding pharmacy locally, they may stock it. If you are in a big enough area to have a center or hospital that does wound care, you might give them a call to see where they get it locally. You can also order it on Amazon if I'm not mistaken.
>
> Coconut oil - I really love coconut oil for skin issues. The compounds in coconut oil have many antimicrobial properties and work well for a host of skin issues from eczema to pimples to nipple trauma. I personally feel it is a better option than lanolin, as one little jar from the grocery store will last much longer, has a wider variety of uses, and costs about the same as a tiny 2 oz tube of lanolin. They can apply it is often as necessary and shouldn't need to wash it off prior to feeds.
>
> Poor Fit - I have found that poor fit, depending on the size of the differences, tends to resolve in weeks, not months. I've also found that biological nurturing helps a lot with the poor fit dyads.
>
> I also want to encourage you to never feel like you are "bugging" anyone! I can honestly say that I haven't found anyone's posts to fall in the category of "bugging" here. Asking for information to broaden your knowledge, and to better help serve families is a sign of being both smart and strong! And I learn something from nearly every post on here, particularly those who ask questions, so you are helping me with my own knowledge as well. I'd definitely say you aren't bugging anyone.
>
> Angela Hartfelder IBCLC, RLC
>
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