We have encounterd the same concerns from the physicians - Peds - FP - the ENT have been VERY supportive.
We have a script that the Peds have agreed to support: In looking at your baby breastfeed I have a concern about how your baby's tongue is working. There is a little flap if tissue that anchors the tongue to the bottom your baby's mouth. Sometimes that tissue is short or tight and restricts the FUNCTION of a babies tongue-to extend, elevate and wrap around your nipple. This can make breastfeeding - getting milk out of the breast hard for your baby or increase pain in your nipple. In addition to breastfeeding - we need our tongue to lick an ice cream cone and French Kiss. I am going to leave a message for you baby's doctor to look at your baby's tongue.
1. We don't mention or suggest that the tongue is "clipped" - Mom's ask and we reply that their doctor will decide the best course of action
2. In the beginning the message to the physician was "eduction" - clipping the tongue is based on function - not appearance - milk transfer or mnatenal nipple pain.
I think what helped here was when a Ped went to an inservice and came back having seen the light. He was willing to listen. He then made a good point - how to L/C feel when a mom comes into the clinic saying " I was told to come to you and get a nipple shield - or an SNS etc. And we are expecte to give them what they want without assessing the problem. It help us change the language we use.  Sue from Utah

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