Lactnetters

About 6 weeks ago I wrote in asking for experience and comments on a
short tongue baby.   We have mostly been occupied with other  problems up
until now (allergy, plugged ducts, etc), but finally are able to look at
baby again.

Baby has not been able to extend the tongue over the lower gum line, and
there is no significant change to that yet (baby is now 7 weeks, but was
3 weeks early).  (It is better in the charm/prone hold, but still only
touching the gum then.)  It acts very much like a short frenulum, but
there is no real visible frenulum.  Also, there is no heart shape and
baby can lateralize and lift the tongue fairly normally--just further
back in the mouth. .  He also still seems to have slight difficulty with
coordinating breathing and swallowing on the bottle and needs to do
catch-up breathing.  (This is less of a problem when finger-feeding)

My question today,( though I'll accept any encouragements or comments
:-), is
WHAT TYPE OF REFERRAL AND EVALUATION  would you recommend for a mom that
you had decided had a short tongue with somewhat receding chin as a major
block to feeding at the breast--with symptoms similar to above?  Any?
Can the tongue be encouraged to lengthen with exercises? Who would know
these exercises?  Or would you recommend only tincture of time and
continued work with breastfeeding techniques and prone positions?  Mom
says she would like to have the frenulum checked if it would be possible
to speed the process of getting baby to breast.

[For those of you who remember my discussing this case before, the oral
hypertonia was/is related to allergy symptoms and resolved with
elimination of ALL cow's milk products in mom's diet.  Now baby has a red
raised rash on the face neck chest and back  which is resolving as she
eliminates the Orange Juice she was drinking instead for the last 3
weeks..........Mom is also off of peanuts and chocolate and taking
lecithin and she has finally gone 2 or 3 weeks without a plugged duct and
is getting her energy back  (Mom did just note bright red blood in the
stool yesterday too so a feeding diary and checking with the pediatrician
again was recommended-----mom also eats a lot of soy products and she
knows I'd like her to cut down on those too.....)]
Little by little we progress.....

Natalie Shenk BS IBCLC
private practice in Findlay Ohio USA
(only here 1.5 years and still establishing my referral base---but I do
have access to colleague connections)