I work in a small community hospital with lots of genetic ties that we
can see with our "local" patients. One week out of 7 births we had 3
tongue ties! We are lucky because our babies go to breast quickly and
get lots of good help, so it's a big red flag to stop and look well if
the babies are not stooling well or "not nursing well" (we do use the
LATCH system and assess at least once per shift).

As to speaking to parents - I find it easy, since I'm tongue tied and
I can't "roll my tongue". My mom must've had sore nipples the entire
three weeks she nursed me. (I have thick posterior insertion and the
worst arched palate you've ever seen.)

If you say, "I think this baby is tongue-tied. Is anybody else in the
family tongue tied?" they usually light up and tell you exactly who is
tongue tied in the family.

We do our best to go back to basics (asymmetric, deep latches) and
sometimes use nipple shields, both with good effect. Our moms all
watch "Follow Me Mum!" to help with those deep latches.

And -- the docs are starting to listen when we ask them to clip a
frenulum, since it's usually not the first thing we try. We actually
had the ENT doctor clip three frenulums BEFORE a year (grrr....) in
this past year, one a baby who had lost a lot of weight and whose
doctor finally listened to me after the CT scan and MRI (because of
the baby's "neurological symptoms" caused by malnutrition). Another
due to a mother who just plain insisted because her brother had so
many feeding and speech problems!

Dawn Kersula in Vermont

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