Wendy: Although I have never worked with a baby who we knew was a hemophilic,
the drop or two blood is an important consideration. However, so are the
current problems mother is having with breastfeeding. Unfortunately,
stretching is a myth. There is absolutely no evidence that the lingual
frenulum stretches over time so you cannot count on it. The frenulum has been
known to rupture, but this may be a bigger problem considering the history in
this case. Rupture is not a guarantee, either, or we would never see a tongue-
tied adult. The risk;benefit ratio needs to be examined here. The longer
mother waits for treatment, the harder it will be to retrain the baby. All in
all, the best thing may be to have the frenotomy done in a very controlled
environment to be sure there are no sequelae from the clipping procedure.

Alison K. Hazelbaker, MA, IBCLC