Show the diagrams of Woolridge's ultrasound studies of breastfeeding.
This will demonstrate the importance of the baby getting his tongue
forward, and relatively flat.  Then explain why tongue tie prevents this
moving the tongue forward.  If you have your own ultrasound of babies
breastfeeding all the better.

If they do not accept this premise, then there is not much hope.  Your
discussion should admit that it is not always possible to predict which
baby will respond to the procedure.

I always mention that the procedure is so easy, so rapid and so safe, if
done with any care at all, that there is no reason not to do it if there
is a question.

Finally, disarm them by proposing a study to look at the effect of
cutting or not cutting the frenulum of breastfeeding babies immediately
at birth where, 3 people, including a pediatrician, and LC and someone
else agree the baby's frenulum is tight.  The babies would then be
followed.  They can't bluster if they refuse to do this.

Jack Newman, MD, FRCPC