I first saw this baby when she was two months old. The mother has come from
New York to California to be with her mother who is a La Leche leage leader,
because she has had a great deal of difficulty nursing the baby. In 1990
mother had a breast reduction surgery.  After birth mother reported lots of
milk and baby doing well, lots of wet diapers and BMs. Until the third week
and then mother reported feeling like she lost her milk,  and the baby had
lost weight. Mom also had severely sore nipples. Mom went to a LC ,who put
baby on SNS and showed mom how to latch baby on. When mom showed me how she
nursed that baby she had the  tube  taped to breast so that the tube was on
the baby's tongue and baby was in cradle hold. She said that her LC said to
do it this way as it was easier. I'm not sure easier for the baby or for mom
to put on. Mom came to see me, so she could be followed while she was in
California. Baby at this time was taking 27 ounces of formula a day and
weighed 10 pounds. Mom reports that there are times when she feel that her
milk supply has increased and then goes away. I first repositioned the SNS
 so that the tube was on top of the nipple away from the tongue and told her
to keep the tube equal to the tip of her nipple.  It had been extending about
1/2 inch. With these adjustments the baby went from 27 ounces of supplement a
day to 20 in about 4 days.  She called me several times and asked about the
fact   that she doesn't always feel the suction while the baby feeds.  What
is difficult is that one breast has no sensation in the nipple but the other
nipple she does. She also told me at times that baby was losing milk from her
mouth. We talked about how to use the football hold and pull down on the chin
while pushing her back on more. This seemed to help alot- per mom. The baby
is now only taking 16 ounces of supplement a day in the SNS. Mom pumps after
each feeding and at the end of a 24 hour feeding( mom wants to do this) has 4
ounces. Mom came in yesterday,( baby is now 2 1/2 months and weights 10 lbs
11ounces) as she was having a frustrating night and day and could not get the
baby on and when she did baby would pull off and scream. The doctor examined
her and she was healthy. . Mom had changed from the large to medium to small
tube over two weeks and with the small tube "it went bad." Mom then switched
to the medium and large and nothing helped. In the office we used the large
tube and showed mom an easier way to do the football hold as well as to
support her breast more for the baby. Baby ate well for the first time  that
day.(Next day- baby is on medium tube.) I decided to check her mouth to see
if her frenulum was short. Mom said before that two lactation consultants had
said her tongue was not tongue tied. The babies tongue extends up to the top
gum ridge but not beyond. The frenulum is not attached at the tip of the
tongue. It is normally placed and very close to the tongue. There is nothing
to clip! The tip of the tongue does not round but appears "square" shaped. I
did a suck assessment and felt the tongue moving up and down on my finger. It
did not seem to mold around my finger. I asked the doctors to look and they
agreeded  that the tongue appeared "short" and "square".  Anyone worked with
a tongue like this? I feel that mom is producing milk. How much she is
capable of producing, I don't know, but I feel there is more going on than
her breast reduction.  Thanks (you can post or e-mail me),  Camille