Thank you wise ladies for this very interesting discussion on
tongue-tie.  It is a particularly interesting subject for me, because
there are no providers in our area who are willing to snip even a severe
case of tongue-tie.

I'm interested in hearing more about what our species did for
tongue-tie, before the "famous midwives with the long finger nails
sniped at delivery" stories.  If we are arguing natural selection here,
would all of these babies have perished from starvation?  If tongue-ties
run in families, would that mean that the children of certain families
never survived long?  If that is the case then, why do we still see
tongue-tie...only because some less than severe cases lived long enough
to procreate, pass the tongue-tie anomaly through the generations and
survive despite the difficulty?  And finally, what about tongue-tie
trouble with our nearest primates?  Is this an issue for nursing dyads
of the chimpanzee, gorilla or monkey families?

Michelle Swanson, LLLL
Wyoming, USA

Rachel Myr wrote:
> When I first joined Lactnet I didn't know how to recognize signs of tongue
> tie and I wondered why some posters were always bringing it up.  I regularly
> encountered women who appeared to have their babies well positioned and
> attached at the breast but were still having a lot of pain and their nipples
> looked very traumatized after a few days of BF. And I met a lot of women
> whose previous baby had been weaned very early, like in the first couple of
> weeks, due to intolerable pain and soreness that nobody could help her with,
> and some of them have been treated for tongue tie in later childhood.
>
> Now I see a case or two of tongue tie virtually every week.  We have about
> 175 births each month in my hospital.  The few studies we have about tongue
> tie point out that the incidence of visually detectable tongue tie is a lot
> higher, like three times, among babies attending BF problem clinics than it
> is in an unselected normal population of babies, where it is perhaps 3%.
> That should tell us something right there.  Can't remember offhand whether
> it was Hazelbaker or Griffith who noted that about half of babies with a
> visible tongue tie had no difficulties feeding effectively and without pain
> to their mothers.  The other half are the ones who may benefit from frenotomy.
>
> If it ain't broke, don't fix it - even if you can see the frenulum is
> attached near the end of the tongue, as long as mother and baby are happy
> and thriving, there is no problem.  After seeing nearly instantaneous
> improvement in feeding effectiveness and comfort following frenotomy in
> pretty much all the cases of tongue tie accompanied by BF problems which we
> have referred, I'm satisfied that our criteria are good enough.
>
> If feeding is going fine, I don't look any farther. If it is not, then
> checking the oral cavity for ANYTHING that could be a factor is a logical
> next step in my book, if simply improving positioning and attachment does
> not solve the problem.  Once we find a suspected tongue tie, they can't be
> evaluated and possibly clipped fast enough for me.  The sooner the better,
> because the baby often needs a bit of time to figure out what they can do
> with their tongue's new-found mobility and we want them to have the chance
> to feed before they go home from clinic.
>
> I would love to know whether tongue-tied babies are overrepresented in the
> group of babies that don't spontaneously start suckling shortly after birth.
>  I'm not aware of any research into that question.
>
> Rachel Myr
> Kristiansand, Norway
>
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