I would bet this baby (who had a tongue clipping already) still has some
fenulum remaining.

I "re-clip" tongues on a regular basis.  Many docs seem to think that
freeing up the front part is enough.  Sweep your finger underneath the
tongue, and I bet it get's "stuck" in the mid-line when you come to the
remaining frenulum.  And sometimes I even have to reclip my own
frenotomies...if I did not get all the way back to the base of the tongue,
or if a submucosal frenulum remains that causes continued trouble.

The other possibility is that the baby was not clipped until over a couple
of weeks old, and has continued old habits of holding the tongue behind the
gumline.  Babies do NOT always automatically do better after clipping,
especially if "older".  I have found it useful to have mom use a narrow
ventair bottle, so baby cannot get any milk unless he creates suction...or
perhaps finger-feed with the end of the tube ina contqainer, so the baby is
using it like a straw with the same result.  Often they need to be fed
"part-way" with a bottle they are used to before giving them the ventaire,
so they will be more likely to be patient and figure it out.

Often these moms will appreciate the break of pumping for a day or two, or
perhaps every other feeding...and they can be doing occupational therapy
with the bottle.


Kathy Leeper, MD, IBCLC
Medical Director, MilkWorks

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