Hi All,

Last Thursday a mom called for a nipple shield, referred by her
pediatrician's office. She is 4 days postpartum, cracked bleeding nipples
with baby #4 (no problems with #1, 2 and 3 nursed over a year each). Sez me,
"Sure I carry nipple shields. Is your baby tongue tied?" She said yes. My
response: "Well, get it clipped!."  Just like that. Almost with a "Like,
DUH" tone of voice.

She said "but my doctor said it didn't effect BF."  Deep breath. "You're
calling for help with cracked bleeding nipples - of course it matters, and
furthermore research shows this condition can affect speech and even facial
development." Gave her the name of two friendly dentists. Mom then worried
that I was recommending she "go behind her pediatrician's back." Oops.
Backpedaled, removed foot from mouth, and muttered something about "second
opinion" and offered her a copy of Alison's thesis to read, and/or a chance
to watch a videotape of frenotomy being done (and explained difference
between frenotomy and frenectomy), and suggested her doctor call the
BF-friendly local dentists.

Never heard back from her. Either she called the dentist, listened to her
doctor, or whatever..... wonder if I'll ever get a referral from that
pediatric practice again? No word from them either. Maybe silence is really
golden.

Now the rant: I live in a fairly small city, about 250,000 people in the
metro area. Plenty of good LCs infest the area in every clinical setting
from WIC to health departments to all the maternity hospitals and two
private practices. How can it be possible that EVERY LC and LLL Leader IN
TOWN knows how to deal with a tongue-tied baby, half the pediatricians know,
there are several great dentists who will do the procedure quickly and
considerately, and yet this one ped group still hasn't gotten the message???

My foot-in-mouth comment has to do with my tone of voice and immediate
response - "well, get it clipped." So much for treading gently on some
topics.  Arrgggh!

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com