Hello wise women,

 

I'm posting as a very new and nervous IBCLC!

 

I am also a LLLL and a mum came today to our meeting with very painful
nipples and a baby predominantly on formula. I have mum's permission to
share her story. I had spoken to her before on the phone and we discussed tt
due to the persistent pain and damage she was getting, blanching and chafing
and the fact lots of people have seen her and said the latch looks fine. I
explained that pain meant something was wrong so she came along to see us.
The first thing I noticed that although baby's tongue was very mobile and
moved upwards quite well there was no visible frenulum (more like a
web/membrane) and that the tongue seemed very short. During the feed(which
was painful even though baby's position was good and his mouth looked well
attached) I felt that he hardly transferred any milk(very little swallowing,
lots of NNS and fretful wriggling-even though mum had milk dripping).

 

I was at a loss really because I couldn't do any sort of manual exam (I was
there as LLLL not IBCLC and haven't bought my insurance yet so haven't
practiced in that capacity yet) but to be honest I really lack confidence in
the area of identifying unusual tongues through examination (I wondered if
this might be a sneaky posterior tongue tie due to short tongue and baby's
inability to maintain good suction without damaging mum). I really couldn't
see the baby bringing his tongue down over the gum line at all-but it's so
difficult to see!!  I hated to refer her to a busy clinic but felt I
couldn't do much more for her other than help her feel ok about feeding the
baby and maintaining supply. How do people gain this kind of experience? I
think I'm more scared of missing a tongue tie than I am of wrongly
diagnosing one that's not there, so I didn't rule it out and suggested she
went to get a second opinion. Any other ideas? Was I completely off the mark
to be suspicious about posterior tt?  I really want to learn from these
difficult helping situations, so am grateful for any information or
suggestions you may have.

 

Katrina Soper LLL Leader and IBCLC in Wales UK.

 

 


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome