Anne,
Make sure mom is elevating the tongue 5-8 times a day to prevent this 
frenotomy from scarring/healing. She needs to lift the tongue 
sufficiently to see the underside of the tongue and frenotomy site for 3 
seconds (with clean fingers, of course). IATP (International Affiliation 
of Tongue-tie Professionals) members have been finding this reduces the 
likelihood of needing to revise a frenotomy. It's not too late for her 
to start if she has not been doing this.

Using a tube at breast might also be helpful, as babies use greater 
negative pressure in sucking when milk flow is lower. Since this mom has 
low supply, this baby has to struggle to get flow. Using a supplementer 
can really help both baby's growth and mom's milk supply. Baby gets more 
flow, sucks more consistently, empties the breast better; mom gets more 
comfort and doesn't have to follow up with bottles.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 3/1/2011 10:17 AM, Anne Brown wrote:
> Permission to Post
>
> I have a 40 year old mother of 3.  First child breastfed for only a few weeks, second BF uneventfully for a year and now baby #3 born with type II-III tongue tie.
> Baby is 8 weeks now and has been giving mom sore nipples from the beginning along with slow weight gain.  Had TT clipped twice (scarred over after the first frenotomy, the last one done a week ago Monday).  Mother is still experiencing sore nipples at latch but eases during feeding, it is bearable and nipples are no longer visibly damaged so things have improved. Baby is still underweight, mother's milk supply is low.  Baby reluctantly takes a bottle.  Mom is taking fenugreek, doing breast compressions, pumping to raise her supply.  No signs of yeast/thrush and mom still has some mupirocin from when her nipples were infected.
> Mother is doing pacifier pull and other exercises to coax the tongue out but cannot afford CST.
> I suspect that the underweight has a bearing on her latch so I have the mom really encouraging the bottle with formula for extra calories after breastfeeding since mom's breasts don't respond well to the pump.  Does anyone else have other suggestions to help relieve her nipple discomfort?
> Annie Brown, FNP, IBCLC
> Greenwich CT
>               ***********************************************
>
> 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

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

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