I keep trying to figure out why the resistance to clipping a frenulum when circs are done so soon post-partum -- generally with no pain relief. Basically, and in a nutshell, because physicians generally think treatment is unnecessry and/or it is dangerous. I heard a PT at a conf. once caution against casual frenulum snipping because she had concerns that cutting anything that anchored a muscle had consequences. The tongue is a set of muscles, not just one muscle. It is the lead organ in oro-facial development. Its stability comes from structural stability of the oropharyngeal area, specifically the hyoid bone. Is this what the docs are worried about? If so, what is there in the literature which gives rise to this caution? Basically what is in the medical literature regarding tongue-tie is unsupported opinion and mythology. Soem of us are trying to restify that by doing research in this area. Tongue-tie is hereditary. Why is there not similar concern when the proceedure is done for speech reasons? How commonly IS this proceedure done for speech reasons? I am going to sniff around the speech path. community resources I have and see if there is literature in their field which might elucidate any of these issues. My literature search of all fields uncovered a lot of information about ankyloglossia, however, not mush in the speech pathology field. There is some excellent research by speech pathologists done back in the 50s and 60s, however, speech pathologists are divided re: the impact ankyloglossia has on speech. Some recommend frenotomy or frenectomy, some do not believe there is any relationship between tongue-tie and speech problems. creative positioning will assist things. If the baby can be latched with the chin cocked so it 'shovels' under the breast and really digs in, the tongue and jaw closure can be located over lactiferous sinuses and off the nipple. This helps both pain and intake. This position looks 'wrong' cause the nose is so backed off the breast, but with mom holding the weight of breast off baby's chin, it can work. Then I suggest mimicing sticking-out-the-tongue exercises, and coaxing tongue out with light touch to the tongue-tip to elicit a thrust. This helps increase range of motion -- esp. is the frenulum is of the thin and stretchy variety. Sometimes these things work well enough that clipping is delayed or prevented. But who knows if this is the best way to proceed. Although these approaches are excellent ways to apply a bandaid to the problem, the infant is still facing oro-facial and pharyngeal development issues if appropriate treatment of the tongue-tie is not undertaken. I could spend hours and hours on this but I think hearing what Dr. Palmer hads to say at the ILCA conference in July this year will go a long way toward addressing this issue. Please e-mail me privately if you want to continue this dialogue in detail. Aliosn K. Hazelbaker, MA, IBCLC, CST