Celine, I see quite a few moms whose babies have tongue-ties and the mom has been told off-handedly by a nurse or even another LC that it is suspected, but there is no sense of urgency so it is ignored. Moms have to be given the sense of how urgent it is to be treated, information about treatment (I email Cathy Watson Genna/Betty Coryllos' article to every client whose baby has a tongue-tie so that they can read it themselves). I let parents know about the lack of education most peds have on the subject and I facilitate an appointment with our ped who clips ( I would say close to 100% of my clients will have the frenotomy done). I never send babies to anyone else anymore, b/c many of the docs who clip anterior ties don't even acknowledge posterior ties and there may well be a pp tie that gets left and baby needs to be reclipped. I just had one baby clipped for the third time (was the charm, though, but poor little babe). I will certainly give moms tips to stop-gap the pain, damage, inefficiency at breast ( sometimes come off breast), but I also tell them that resolution rarely happens w/o clipping. I do not think it is acceptable for peds to be "not too willing to clip". Babies and moms have a right to feed at breast and peds have an obligation to do everything possible to make it happen. Since you know what the problem is, there is no reason to look for anything else--the problem needs to be solved and the frenulum needs to be clipped. I would, however get this baby for CST, as her birth was absolutely brutal and I doubt it can be true that she has adjusted to life outside the womb well at all--her little body and psyche are holding too much trauma. Besides, I believe babies with tt's needs structural work to release compensatory behaviours. We will sometimes use finger-feeding, a pacifier or other techniques to help babies learn to use their tongues, but I find the CST does the trick for the most part. Celine, looking at the bigger picture, I think this situation is such a good example of how our language drives what we think of as normal and how we define the infant's experience. What is an induction for lack of progress? Gestation is its own progress! I saw a mom today whose baby was born at 41+3--yes a midwife, of course and she kept talking about how her baby was so late!!!! Look at how far we have moved normal so quickly. This is a baby who so badly needs regressive therapy--to self-attach. I usually use the bath, but as more babies are born by cesarean, we have to avoid the water for many. Baby wasn't having trouble tolerating labor--baby was having trouble tolerating induction. And the epidural and the morphine. Baby wasn't allowed to be STS or to nurse or to be with her mother? There is no way that such an experience can cause any outcome other than a desperate trauma that drives and thus integrates compensatory behaviours. This baby's own inner guidance system was completely annihilated and we wonder why she cannnot feed? Why she might be upset, distressed, in a constant sympathetic state (thus not interested in feeding), even angry? Life has not been good to this little one so far. Now baby is on a bottle and her entire experience of life is one in which things have been done to her, completely negating her instincts, her wiring, her right to be in control, to direct her own feeding and thus the nature of her relationship with the world. How terribly tragic. And we as a culture have named it all normal.... Jennifer Tow, IBCLC, CT. USA Intuitive Parenting Network, LLC "Subject: Clicking sound at the breast First baby for this mom. Normal pregnancy without any complications. Full term. Induction for lack of progress. Ended up with a c/s during the middle of the night (something like 12 hours after induction started) because baby was not tolerating labor. Epidural with Morphine was used during labor. Baby was born without any complications. Adjusted well to extra uterine life. I am not sure if baby was allowed skin-to-skin and breastfeeding in the first hour. In the first 24 hours, baby never took breast. Too sleepy, not interested. Tried several times without success. Baby was not put skin-to-skin and baby was in the nursery because of protocol (all c/s babies are in the nursery for first 24 hours unless dad or visitors are with mom). Baby started turning jaundiced and was put under photo therapy at a little over 24 hours old. Baby started to receive formula via ff after attempts at the breast and breastfeeding was attempted every 3 hours. No pacifiers or bottles were given to baby. Baby started getting hungry and started to root for breast. From what I was told, baby couldn't latch on to the breast and would push away and scream at breast. They said she would pinch lips closed and refuse to suck. A nipple shield was tried without much success as baby would just suck on the end of it. Suction was said to be more chewing than sucking. When I saw this mom, she was over 48 hours pp. Baby was well awake and rooting. She opened wide and did latch to the breast well but was making these awful smacking loud noises sounding almost as if she was smacking her tongue from the roof of her mouth to the bottom of it. She was putting no suction on the nipple and was on a few occasions hurting mom by bitting down or clapping down on the nipple. Every once in a while, she would get in a few sucks but would go on to the same clicking noises. The sucks were not very strong or adequate to remove milk. I did an oral exam and found no abnormality except a short frenulum that seemed to be tied rater in the back of the tongue. When attempting finger sucking, baby could not extend tongue further than the lower lip. She would cup finger with tongue but you had to try several time before she did it right and even then, it wasn't a full cupping like other babies usually do. Suction was good. Baby stayed calm while attempting to breastfeed and did not push away from breast. What I recommended this mom do is try baby at the bare breast for at least a couple of minutes but not overly because nipples were starting to get sore and baby was chewing them out. I said if baby wasn't getting it after a few minutes to finger feed baby while holding baby close to breast. Do lots of skin-to-skin with baby and to pump after every attempt at the breast. Tube at the breast didn't work either so that is why I suggested ff. I also showed mom how to stimulate suck and how to try to do suck training with baby to help with tongue extension and cupping. I asked the nursery nurse to have peds look at the frenulum but I guess she never did. I guess mom ended up giving up and offering bottle. Did I miss anything? What else could I have done? Our peds aren't too willing to clip frenulums.... Thanks for your imput!!! Celine Cormier, RN, BN, IBCLC ________________________________________________________________________ AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com. *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]