Laura,
I can see two issues if this mother followed the advice immediately.
- If a baby is aspirating, it is surely better that it is human milk than a 
foreign substance (if there some aspiration continued)
- The mother's confidence and capacity to cope are fragile, from what you 
wrote. She has had a difficult time and sounds at the end of her tether.

I wonder if there are any details in the report from the swallowing study on 
the extent of the aspiration. Did the test results state the underlying 
reasons, i.e. *why* the vomiting and consequent aspiration is occurring? 
The position you mention that is necessary - at all times - to prevent 
regurgitation, makes me think there may be more to this. Have you thought of 
discussing with your client getting a second opinion?

It may be that this mother opts to wait for the release of the tongue and 
lip ties if that is soon. If the release doesn't help, more investigations 
would be prudent - to see why all these difficulties are happening. "What" 
and "why" -knowing what is happening is one thing, but knowing more about 
underlying factors could help. A wise friend and colleague used to say, "If 
you find one factor, look for three."

Whatever course is taken, this mother will appreciate your support and 
knowing that you are there for her. She sounds a dedicated mother who is 
doing her best to get help in difficult circumstances.

Virginia
~~~~~~
Laura S wrote:
Mom has not scheduled the revision but she had already scheduled a 
swallowing study which took place today.
The study shows that baby is aspirating.  Therapist wants baby to be on 
thickened pumped breastmilk.  Mom is devastated.  She does not feel able to 
cope with pumping and bottle feeding as well as holding baby upright at all 
times or baby vomits a lot of the feed.

I know that aspirating is common for tongue-tied babies and mom may still 
consider revision.  Is it appropriate for mom to continue to feed at the 
breast and not take the advice of thickening her milk and bottle feeding?

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