Post tongue tie release concerns

Hello all!

My baby boy was born at 36 weeks 4 days. He is currently 8 weeks old. He is formula fed since 2 weeks old. At three weeks old we had high tongue, lip, and buccal ties released. Prior to the release, LO couldn’t latch for very long, on the bottle he had major leakage, clicking, super noisy, choking, reflux, congestion and took forever to feed. Post release, we are still having a lot of congestion. Primarily at night after his night feeds but also during the day. At night, when laying on his back he will randomly gag or choke. This is after over an hour being upright after eating. I believe we are dealing with silent reflux too. He is also currently seeing a chiro for body work stuff 1x a week. That’s been very helpful.

We had an IBCLC come out. She was also wonderful! I have had concerns with his suck swallow breathe pattern. Well she confirmed it and saw how stressful it is for me to feed baby boy because he will sometimes still choke during feeds although not as often as before. She said his tongue needs retraining because he’s not lifting the back of his tongue enough to seal things off and also is recruiting his jaw to keep a good suck. She gave us exercises to do at home along with exercises to address tension in his little body. . I’m trying my best to get them all in on top of all the other things but it’s so much!

I’m concerned for my little guy. He is gaining weight just fine and when I bring up concerns with the doctor he’s like what’s the problem? He’s a good weight. But I can’t lay him down on his back even elevated doesn’t help. I don’t think he’s getting solid sleep and neither are we.

He can’t go longer than 2hours between feeds and is only giving us 1 3 hour stretch at night. I don’t know if that’s related at all.

Questions: When did you see improvements post tongue tie? I saw other improvements pretty quickly but this swallowing/tongue part is worrying me.

Ami worrying too much? I feel like I’m failing him because even when I do the exercises I feel like they aren’t being done well enough. Not like the lactation consultant. She made them look so easy. It’s not easy for me

Do I need to give baby more grace bc in addition to the ties he was born earlier?

We currently feed side lying. Lansinoh bottles slow flow. I have tried all kinds of bottles and nipples too.