Regarding the family of Philippine heritage and not believing in tongue
tie... Here are some quick thoughts that you may have already considered,
but just in case...

1. Where does the family live? Does it have a large community of people of
Philippine heritage? Can you or the mother contact a community center or
develop other contacts that might help you find a physician of Philippine
heritage (anywhere on the planet who is willing to help) who *does* believe
in tongue tie and the importance of breastfeeding?
2. Can you engage the tongue-tie knowledgeable physician in helping to
educate the other physician? Has she had success in influencing him in any
other arena? How did she do it? Does she know of anyone else who is
influential with him? Would she know what resources (from people to any
form of media) he might respect?
3. Have you been seeing only the mother? Can you ask the mother who is most
influential in the family--family member, religious leader...? Can you see
the mother and that influential person? Is there someone who could be
educated about tongue tie--or at least the importance of
breastfeeding--that then might serve as an advocate for the mother? What
about seeing the mother along with the father? What about seeing the
mother, father and the father's parents? Having on hand photos of
tongue-tie? Having on hand breastfeeding materials in their native language
(presuming it isn't English) with photos of mothers from the Philippines?
4. What about referring the mother to a breastfeeding support group in
which other mothers might be able to validate this mother's experience with
sore nipples, conflict with family, tongue tie, grief about giving up
breastfeeding...?
5. What about putting the mother in touch with another mother who has
experience with tongue tie?
6. What about exploring all options involved in increasing milk supply for
an exclusively pumping mother (check the quality of the pump--does she need
a different pump or does it need to be adjusted, check flange sizes, what
about hand expression, check frequency and duration of pumping sessions,
explore galactagogues...)? If the mother can protect her milk supply then
she at least can provide her infant with her milk and she *buys herself
time* to work with her family and find resources that they might respect
(that is, that they find culturally acceptable).
7. Would anything in my articles, "Helping Mothers Create Breastfeeding
Allies" or "The Cultural Art of Breastfeeding" be helpful? (It's on the
publications page of my website.)
8. Can you find out what about bottle-feeding is preferable from the
father's perspective and then work with the mother to address those
concerns?
9. Can you come up with at least three realistic options of first next
steps so that the mother's sense of choice is enhanced?
10. Is part of the problem in this family the possibility that they
personally or culturally see a stigma attached to a physical difference in
their child? Would exploring this issue help the family move to accepting
that there is a problem and searching for a solution?
11. Is this family conflict the tip of the iceberg? Would referral to any
social services by appropriate?

Wishing this mother the best possible solution in the context of her real
life,

Cynthia

Cynthia Good Mojab, MS, IBCLC
Ammawell
Email: [log in to unmask]
Web site: http://home.attbi.com/~ammawell

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