Hi Jillian,

Did you also check for lip-tie?  Tongue and lip-tie are often found together and baby's long feeds suggest that latch is still not optimal.  Also I agree with Jean that CST can be necessary to complement tongue-tie treatment.

Has mom done good aftercare, lifting the tongue a few times a day and sweeping back and forth under it to massage the revision site?  These are important to prevent reattachment.  Also suckling exercises can help retrain the tongue.

I would ask mom to consider the CST as soon as possible and check for complete tt revision and check the lip also.

Until mom is able to try these things, she could try feeding in a breast hanging down position to make feeds quicker.  A client of mine whose baby was tongue-tied discovered that her baby fed much quicker in this position when she tried it to release a plugged duct.

Because mom was also having pain with no breastfeeding, it could also be due to Raynaud's as suggested by others.  I would try having a heating pad right there for when baby unlatches and use it immediately after baby releases the breast.  Also, for between feeds, wool breast pads are fabulous for keeping mom from getting damp chilled nipples.  They are also antibacterial and allow airflow without cooling or overheating.

Laura Spitzfaden, LLLL, IBCLC

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