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Fri, 6 Jun 2008 19:19:22 EDT |
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Jenny writes:
I don't think we can assume that a surgeon looking at a posterior tongue tie
will have that understanding. Not every tongue tie needs to be fixed. It
may be helpful to develop language to describe the importance of the impact of
tongue tie on feeding and not just to describe the anatomic
components.
This is a crucial piece. The presence of a tongue-tie is not the reason for
referral. (I have seen ties like rubber bands that stretch, cause no one
trouble, pain or effort.) There has to be an impact on the nursing dyad. The
times I have accompanied moms to see doctors I knew would not clip, but they
wanted to go to whoever their family or pediatrician recommended, I was very
careful to describe the impact on function. All the moms had significant pain,
many had significant nipple wounds, and babies had feeding issues of latching
and/or efficient milk removal. These physicians were still unimpressed,
because the babies could bottlefeed, although often not efficiently either. Some
physicians did understand the issues of function, but still would not do the
release because they were afraid the bleeding would be too much, or because
they lacked the experience with this kind of tie. I respect this. Mostly
thought it was devaluation of breastfeeding as normal. Some moms got dejected and
just quit trying at all, others went on to go to someone who could evaluate
them and treat them.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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