<<The ENT agreed with the family doctor, he felt that
the tight frenulum was not severe enough to warrant
frenotomy, because he will grow out of it.

UGH!!!!!   So after hearing that, the mom decided that
she was in too much pain and the baby was too
frustrated, she is not even going to pump, she's just
going to formula feed.>>

Pam, will you forward the outcome of this case to the
2 MDs consulted?  (I assume you would edit out the
"ugh" though we all feel your pain...)

How do others handle this?

Having the eggs to follow-up accomplishes two goals:
--  Everyone enjoys a lovely learning experience.  It
may be that this is what it takes for the 2 physicians
to connect with the outcome.
--  Your report may raise awareness of the
contribution of IBCLCs.  Perhaps one of these
physicians will consult with you or refer patients to
you when the issue rises again.  (Don't laugh!  It
happens!)  It could even happen that this baby's
frenulum could get another look, mom willing.

Once I helped a mom whose third son had a severe
tongue-tie.  I gave her referrals to local MDs who
could assess and clip but the stumbling block was her
husband.  He felt that just as they had chosen not to
circumcise, they could not cut the frenulum the child
was born with.  I remember thinking, If this was my
baby I would quietly take care of this and not mention
a thing...  But it wasn't my baby and it wasn't my
husband so I vented to local lactation pals & let the
case continue to haunt me.  The mother stopped bf due
to badly damaged nipples but continued to pump and
feed expressed milk.

For the physicians on the list:
How would you suggest LCs report and follow-up in
cases such as Pam's where there is disagreement or
perhaps misunderstanding about appropriate course of
action?

Susan Johnson MFA, IBCLC
Salt Lake City, Utah USA

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