Hi to all.  I don't post often any more, but this topic is near and dear
to my heart.  Like Barbara, I also bear a stamp saying I can identify
posterior tt's! By way of explaining my history and also of updating for
those who already know it, I have two grandsons with posterior tongue
ties.  My dd had first three years ago in Hawaii and it took almost
three months to get someone to clip it.  She never brought in an
adequate supply, despite trying everything, probably because his nursing
was woefully inadequate the first week, before we figured out there was
a real problem, and he was her first.  Baby #2 is now a little over 5
months old, born in Virginia Beach, and she has never been able to get
his tongue (which looks identical to his brother's, possibly worse)
clipped.  The closest she got was a pediatric ENT who offered to put him
under a general and take a look at it, which she wasn't willing to do at
the time.  This baby is still exclusively nursing and I attribute it to
a couple of things.  First, this baby refused anything else!  He is a
vocal and determined little guy and he simply wouldn't take "no" (read:
bottle or formula) for an answer.  She used SNS for a while, he would
nurse but somehow not take much of anything from the SNS.  He showed a
preference for her milk, even over donor human milk! Also, he is her
second and he is much more aggressive than his older brother!  He still
shows some symptoms, like choking during feedings, but they are making
it work.  His mother lived with pain at EVERY feeding for first three
months and has dealt with yeast the whole time.  She's my daughter so
she knows the options and has tried most all of them to get rid of it.
In my current position, which is in the state health department, I know
the OT who runs some of our state programs and had told her about my
first grandson.   She said ENTs she worked with in another state clipped
these types of tt's, no problem.  I brought in pictures of second
grandson's mouth after he was born and she said he needed to get it
clipped asap!  

The problem with these ties is not just feeding issues, but, as we know
from Brian Palmer's site, also a whole range of issues that affect
health and even self-esteem.  One more factor to consider is the
possible effect on speech.  My first grandson didn't speak at all until
he was 2 1/2 and in speech therapy.  That was the OT's concern in
strongly recommending clipping.  I guarantee you, those frenums don't
get smaller as the child grows, so clipping them in newborns is much
less of a procedure than in an older child.  I still think my second
grandson will need something done at some point, but for now, they are
happily exclusively breastfeeding, something which never happened with
the first!  A less determined and supported mother wouldn't be.  As for
resources, Carmen Fernando has a website now, http://www.tonguetie.net/
which has some good pics from the book.  Her book (which preceded Cathy
WGs, though Cathy herself helped us identify the problem!) was the one
that made me understand what I was seeing with a posterior tt.  I
attended a Wolf and Glass conference a short time after this and showed
them pics of my grandson's tongue which they asked for digital copies
of.  I've had a few private clients since then whose children had a
posterior tt.  A couple were clipped (one at three months and exclusive
breastfeeding was established for the first time.)  One wasn't and they
weaned.  With the directive in mind, "first do no harm", I think the
question is what is the worst thing that could happen if the tongue is
clipped?  Complications are rare, but possible.  What might happen if
the tongue is not clipped?  Many, many possible complications, some
maybe not seen for years.  I worked with a nurse who showed me her
severely restricted tongue.  I had no idea she had it!  She had
accommodated quite well.  Then she told me about how she was always
embarrassed about it, couldn't lick ice cream cones, etc,  and wished
she could get it clipped.  In fact her dentist kept bugging her about
it, but now it was a much bigger deal and she was scared to do it!
Don't underestimate the possible effects of leaving a tt alone.  It
isn't JUST about feeding.

There.  I've said  my piece!

Marsha Glass RN, IBCLC
Indiana

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome