----Cindy Anderson <[log in to unmask]> wrote:
>... While researching
> difficulties with breastfeeding I came across some literature about a
> condition called Ankyloglossia, also called tongue tie.
> For those of you that have worked with tongue tied babies, how were
> their situations handled? Did they undergo a frenotomy? Was it done on
> an outpatient basis with or without the use of anesthesia? Was it
> successful, if performed? Or do tongue tied babies nurse okay without
> intervention?
>
> Medline Plus. Medical Encyclopedia: Tongue tie (2006). Retrieved on
> March 14, 2006
>
> from
> http://www.nlm.nih.gov/medlineplus/print/ency/article/001640.htm
>
This Medline Plus does not seem a good ref. No supporting documentation provided for its/author's assertions. (Am attaching some additional refs that you may find of interest.)
We've (LCs where I work) assessed a number of tight/short lingual frenulums that were subsequently "clipped" within hours to days without anesthetic. (And we've also assessed a number that the pedi dismissed in spite of continued BF difficulty for babies and/or nipple trauma for mothers.) Have seen frenotomy be a quick "cure" and then again not - often due to accompanying higher palate. (Tight frenulum is a oral midline issue, and one midline issue often means there's another.) Until general anesthesia is used for infant circumcision, I wonder why it would be recommended for this procedure, which (actual clipping) is accomplished in less than 30 seconds...
Amir LH, James JJ & Donath SM (2006). Reliability of the Hazelbaker assessment tool for Llngual frenulum function. International Breastfeeding Journal, 1, 3. Available online: http://www.internationalbreastfeedingjournal.com/content/pdf/1746-4358-1-3.pdf
Ballard JL, Auer CE & Khoury JC (2002). Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Pediatrics, 110(5), e63. Available online: http://pediatrics.aappublications.org/cgi/reprint/110/5/e63
Bowen C (2006). Tongue-tie: Ankyloglossia or short lingual fraenum (rev.) Available online: http://members.tripod.com/~Caroline_Bowen/tonguetie.html
Coryllos E, Genna CW &Salloum AC (2004). Congenital tongue-tie and its impact on breastfeeding. Breastfeeding: Best for Mother & Baby (AAP Section on Breastfeeding, Summer), 1-6. Available online: http://www.aap.org/breastfeeding/8-27%20Newsletter.pdf
Genna CW (2002). Tongue-tie and breastfeeding. Leaven, 38(2), 27-29. Available online: http://www.lalecheleague.org/llleaderweb/LV/LVAprMay02p27.html
Hazelbaker AK (1993). The Assessment Tool for Lingual Frenulum Function. Columbus, OH: Author (Masters degree dissertation).
Kummer, A. (2005, Dec. 27). Ankyloglossia: To clip or not to clip? That's the question. The ASHA Leader, 10(17), 6-7, 30. Available online: http://www.asha.org/about/publications/leader-online/archives/2005/051227/f051227a.htm
National Institute for Health and Clinical Excellence (NICE (2005). Division of ankyloglossia (tongue tie) for breastfeeding. Intervention procedure guidance 149. London, England: Author. Available online: www.nice.org.uk/IPG149distributionlist
NICE (2005). Division of ankyloglossia (tongue tie) for breastfeeding. Understanding NICE guidance – information for people considering the procedure for their baby and for the public. London, England: Author. Available online: www.nice.org.uk/
Karen Gromada, MSN, RN, IBCLC
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