Beth,



Any possibility of a posterior tongue tie that was "missed" during the first revision? I have seen this happen several times recently. Usually when it was what looked to be a straightforward tongue tie was clipped. There was still a posterior restriction keeping the baby from removing milk efficiently. Once that was resolved the baby did much better at the breast.



Holly McSpadden IBCLC



Sent from my iPhone



> On May 26, 2015, at 5:53 PM, beth mcmillan <[log in to unmask]> wrote:

> 

> Hi all

> Need some help with this. Permission to post. Challenging birth, tongue tie baby had body work and release by very competent provider. Baby was not at breast for weeks, mom worked hard at pumping and baby-led bottle feeding. Baby finally did go to breast with nipple shield, mostly for comfort. Then progressed to nipple shield and LactAid, then LactAid with no nipple shield (yay!). Test weights done correctly with sensitive scale show intake is exclusively from LactAid. When at the breast, full and ready!, baby fusses shortly after latching - of course, baby wants flow. Sooooo.....my question is...what the heck? There is lots of milk, really lots. Babe can move milk from LactAid with no help. Mom does massage and compression. Where is the letdown. She herself wonders if it is inhibited d/t stress, neg associations, etc... This mom has done an exceptional job; built a milk supply from nothing, loved her babe back to the breast, worked with latch, healed very damaged nipples, cried and pumped and sweated over this. Kiddo loves the breast and is exclusively fed at breast with LactAid with mom's own milk but then mom has to pump for the next feeding. Please tell me I haven't just overlooked something simple...how can this be. Mom let's down for pump but not baby? They've both had body work, she knows about relaxation, we've played with whether babe is just more effective with shield (not) and tried other positions. Thoughts please?

> 

> Thanks so much

> Beth McMillan IBCLC

> Ottawa, canada

> 

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