Hello again, Wise Ones! 

Permission is given to post. I am working with a dyad who at 7 wks. pp is still 
nursing painfully and have since birth. Baby did have noticeable TT at birth 
(runs in the family) but at this point tongue extends past bottom lip and is 
pointy. Mom used shield to nurse for first several weeks but has only used 
recently out of defense when her nipples are too sore to nurse. Baby has very 
strong suck and clenches some. Mom says it feels like his tongue is made of 
sandpaper. Most of the time, Mom has vasospasms and lipstick shaped nipple with 
white line after nursing. However, even when latch looks great from outside and 
nipple is not misshapen after feeding, Mom reports pain throughout. Baby does 
not like bottle and has to be coerced to take it. Mom has begun pumping out of 
defense. She is very committed to nursing and has been tolerating up to this 
point. She has seen three IBCLCs (including myself) and three peds have assessed 
baby for TT -- most recently, mom was told by ped that clipping would only allow 
a couple of mm at best and after three weeks it was a bloodier and more painful 
procedure and he didn't recommend it.

Saw Mom Friday and instructed on tongue exercises. Issued electric pump and 
urged Mom to feed baby from cup to encourage more tongue extension. Also, am 
asking Mom today to try nursing in prone position. M has quite large breasts. I 
don't believe this is a OA-MER issue, either, as the pain persists throughout 
the feedings. Mom's supply is good, but as she is dreading nursing more and 
more, her commitment to continue is at risk.

I am looking now for an ENT in the area to refer Mom and baby to. Mom is a real 
trooper but I fear she's reaching her point of intolerance. Any suggestions 
would be much appreciated.



Liane C. Varnes, IBCLC

“I've Learned That People Will Forget What You Said, People Will Forget What You 
Did, but People Will Never Forget How You Made Them Feel.” - Maya Angelou


      

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