Hi Everyone,
Would appreciate some feedback as to whether or not you have noticed a
larger number of tongue and or tongue and lip ties that are causing
significant breastfeeding issues in your practices. I practice in a small
city in Canada, and I am the only IBCLC- where a few years ago there were 3
that worked in our area.  I have been certified for almost 10 years (re-
writing in the fall) though only working fully as an IBCLC at our Mother
Baby clinic for 5 years.  The first year or two in this role, I was only
really good at picking up on the really obvious ties, however I feel the
last 3 years or so have really refined my skills at assessing for ties. I
do not do this ‘routinely’ for dyads that are doing well- only for those
that are struggling. The only problem is, I feel like the vast majority of
the dyads I see struggling beyond the first 2 weeks or so all seem to have
ties, either just tongue or tongue and lips. Which seems like just too
large a number. While we do try conservative management for a reasonable
amount of time prior to seeking out options for release, and in almost all
cases, feedings improve with releases, it does seem statistically almost
impossible that this could affect such a large number of dyads. So it has
me concerned that:

1) I have become ‘lazy’ with assessments, and rely on what seems to be a
‘quick and easy fix’. Though, if ties were not the issue- then it seems
logical that releases would be of no benefit...

2) That due to the very large percent of both medical and non- medical
supplementation that occurs in our facility- most often with bottle and
nipples despite our best efforts to educate parents and staff otherwise,
that babies are developing really un-coordinated and dysfunctional suckling
techniques, and releases just kind of help ‘reset’ their patterns...

Thoughts?

Thanks!
Heather Neville, RN IBCLC

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