Hi Jan,
So sorry that you are all struggling so much with your new grandbaby.

One strategy that has helped some babies with similar situations in my
practice (a short free tongue even after frenotomy) is some gentle
circular massage on the tongue with a fingertip.

I teach mom or dad to offer their clean finger to the baby to suck, soft
pad side up against the upper lip until the baby opens.  The finger is
slid into the baby's mouth until the tip is at the junction of the hard
and soft palate.  (Babies with a high palate may have a strong gag
reflex, and may need some milk at the same time [fingerfeeding] to be
able to inhibit that gag reflex).  During sucking, many babies with
short tongues or short free tongues will retract the tongue behind the
gum ridge.  When baby does this, mom or dad gently incline the fingertip
downward onto the posterior tongue and massage in a tiny circle with the
nail side of the finger.  This often helps babies to keep their tongue
as extended as possible.

Then to help babies groove the tongue to help stay on the breast, you
can try a pacifier tug of war exercise.  Use a long cyllindrical
pacifier (playtex binky comfort flex is one I like) and let the baby
suck it, then start gently tugging it outward while inclining the tip
downward on the posterior tongue.  "Let the baby win" by not pulling it
out of the mouth, but do make the baby work a little bit.

Those two strategies together have been helpful for babies in my
practice with very tight posterior tongue ties, even without frenotomy
or frenuloplasty.  One baby took over a month to be able to latch and
breastfeed exclusively, so tell your dtr to hang in there.
Catherine Watson Genna, IBCLC  NYC

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