Agreed Pat.  Thank you.  As a mother of 4 tongue tied breastfed babies, I can confirm that we see different manifestations of these restrictions.  I did not want to jump at having a release right away because she was not in pain, but now I am leaning toward it more.  Also, to confirm, the baby is breastfeeding 5x and bottle feeding 5x for a total of 10x/24 hr when mom works.  I realize returning to work and being for months can affect baby's interest in nursing/weight gain, but the weight gain actually started to improve with the bottle feeding.  Even with all of those bottles, weight gain is not great which makes me think that baby is not nursing well too (probably due to restriction), but I want to make sure I'm not missing something more serious.  Where is all this milk going?  His output is not ideal, but he gets 4-4.5 oz per bottle.  I suppose it could be that he's not getting much at the breast, but my one test weight showed a 3oz transfer and mom said this was a typical breastfeeding session for him.  Mom feels she is going to have to supplement with formula while at work because she can't keep up with his 20oz requirements while at work.  Any other suggestions?

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