Margaret,
I often see babies who have been to one or more LCs before me. Many times I am seeing them b/c the stop-gap measure that were put in place previously only provided temporary relief and the tongue-tie just needs to be clipped. Many times these moms will say that the tongue-tie was mentioned and no referral was ever made. It is much more difficult for babies to overcome compensatory behaviours when they are clipped later rather than sooner. I used to take much more of a wait and see approach than I do now, b/c I know that waiting can backfire. I also believe that it is essential that all babies who are clipped receive CST as part of the care plan. When I do suggest waiting, it is only b/c we are trying CST first to see if the compensatory behaviours resolve with manual therapy. 

My own daughter nursed for 5 years with a tt, and by most standards one would have thought she did okay. But, she is the only one of my babies with whom I had a raging oversupply, the only one who screamed at many feedings for 6 months, who could not ride in a car seat, who had "colic" and so many other stresses during her first year. She is the only one who had croup as an infant and snored until she was about 7, when she was Rolfed and it completely resolved. She needed a lot of bodywork to correct numerous compensations. I wish very much that I had known then about her posterior tongue-tie. Today, she is a student at a high school for the arts and her tt clearly affects her ability to project her voice--always a reminder. 

Is it over-diagnosed?--not likely since peds rarely seem to diagnose it and LCs don't diagnose. Are we seeing it where we ought to be seeing other things? As Dr Coryllos says--a tt is rarely seen in isolation from other problems. Just having a tt causes other problems and clipping alone may not be enough. I struggle with this issue myself, but in the past year, I have only had two situations in which clipping a tt combined with CST did not assist in fully restoring function. So, for now, I am erring on the side of referring and asking a lot more questions about the "why" of it than ever before.



I do sometimes wonder, even if we can make breastfeeding work ok with 
exaggerated asymmetrical latch, how vehemently to to encourage parents 
to take further action on the posterior tongue ties, because of the 
potential for longer-term issues. 

Margaret Sabo Wills, LLLL, IBCLC Maryland
(who's written more in one day than in a year of largely lurking)


 


 


Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC

 


 

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