Amy,
     Our local "baby ILCA" professional organization (Lactation Consultants Assoc. of Gtr Wash. DC) just had a great presentation on tongue-tie & impact on breastfeeding by a pediatric ENT out of Children's National Medical Center in DC.  He was a relatively new specialist and has a breastfeeding baby, which certainly contributed to his enthusiasm.  He mentioned how it can be hard to get some physicians to change their minds & still use out of date practices.  He suggested to keep giving them recent journal articles.  In addition, the fact that the AAP really has an emphasis on promoting and protecting BF, that should be enough to want to consider all possibilities (including tongue-tie).  Also, try & get one peds "in your corner" who may be able to sway the others, particularly when there is good feedback from mothers who have had their baby's frenulum clipped.  
     And re:  our scope of practice...while we don't "diagnose", we have a professional responsibility to share our assessment (what we see that "may" impact BF) with not only the heath care provider, but the parents as well...it's called 'informed consent'.
     Here are a couple of recent articles I found.
         Good luck.
           Lou Lamb RN MS IBCLC
           


Isabella Knox 
Tongue Tie and Frenotomy in the Breastfeeding Newborn 
NeoReviews 2010; 11 (9) : e513-e519.

Benjamin H. Miranda, Catherine J. Milroy
A quick snip – A study of the impact of outpatient tongue tie release on neonatal growth and breastfeeding  
Journal of Plastic, Reconstructive & Aesthetic Surgery - September 2010 (Vol. 63, Issue 9, Pages e683-e685, DOI: 10.1016/j.bjps.2010.04.003)

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