I don't want to throw egg nog on your Christmas cheer.  I do think we
need to make sure we don't expect too much from cutting frenulums
(frenula).  I can say this as someone who does as many as 4 a week,
regularly, week in and week out, and am quite an advocate for doing
this procedure.

I am absolutely convinced that there are times when cutting the
frenulum has made a tremendous difference, immediately.  But a few
weeks ago, I had two sobering cases.

In the first, a mother had come to the clinic with sore nipples, and a
baby who was gaining poorly.  The baby had an undoubted tongue tie.  I
did my usual for sore nipples and poor gain (fix the latch), but the
mother did not want the tongue tie cut--she wanted to think about it.
Two weeks later, the mother came back with no sore nipples, a baby who
had gained a pound (over 400 grams), and the tongue tie still there.

The very next patient was six months old.  The mother brought him for
something quite minor about solid foods I think (love these patients).
The baby had one of the most obvious tongue ties I've seen.  The
mother said she never had sore nipples, the baby never had trouble
latching, the baby always grew well, breastfeeding exclusively (he
weighed 9 kg, about 20 lb at six months).

Go figure.

Frozen breastmilk can be used mixed with solid foods.  How about
breastmilk popsicles?

Jack Newman, MD, FRCPC