So, I went to the appointment and it was actually pretty useful!
As I had come to suspect, Sprout has limited upper lip mobility (his lip is pretty short from nose to mouth and the frenulum that connects lip to gum is pronounced) and an extremely high palate. Those things often go along with tongue tie.
When he nurses, he uses compression more than suction (like you guys, right, Mosaic?). That's why things hurt and why he can't maintain the latch.
So we've got some exercises to stretch and pull his upper lip and cheeks. We're also supposed to let him suck on our finger and touch the roof of his mouth to desensitize the palate (since his tongue likely doesn't reach up there) and get him to flip out his upper lip when sucking.
She also gave us some tips for attemping to introduce the bottle -- stiffer nipples, smaller base, and how to do cheek and chin support to keep his form.
So, aside from getting some ideas on how to help, it's nice to hear again that I'm not crazy, that he does have significant impediments to nursing correctly. She also told me that there's another doctor who does tongue clipping, so we may go and get a second opinion on whether the initial clipping was far enough. He also does lip clipping, so that might be an option.
And, apparently, it's up in the air whether we'll be able to go back for more therapy -- our insurance has denied therapy claims before for breastfeeding assistance because they think the mom should just go to a bottle.
Give me a second to be frustrated and angry that we're still dealing with this at 3 months....
Okay. Thanks. Better now.
The good is that he's still gaining weight like a champ and my supply is still holding up. He nursed briefly at the appointment and took in nearly 3 ounces!
We're both just stubborn, I guess. Or I'm too cheap and lazy to use formula.