Hello,
I would like to give witness to this, some 40 years ago, all tongue-ties
(and maybe TT which were not so "tied") were clipped, it was a general
procedure; then there was a study (I think it was a study) which showed that
tongue-ties did not interfere with speech, so it was no longer useful to
clip them;
Here, we had a large gap of time with very low breastfeeding rates (after
quite zero) and so bad instructions/cares that moms had no milk or had very
sore nipple and stopped very early; and, as none could really help moms, it
is difficult to guess the whole fact. Imagine the advices like: give bottles
of water, only 10 mn a breast, every 3 hours, give formula during the first
3 days...)
What I know is that there was a moment the first associations of mothers
(like LLL) "arrived", but very few physicians were still interested in
breastfeeding, so they did not "hear" the good advices; and moms who were
not helped by other moms weaned really early.
Now our rates are growing, the number of physicians involved, trained, in
BF, has grown. But they are really rare; many health care providers still
train students with "bad" advices;
Concerning physicians: at the moment: they quite all stay on the stage of:
"no worry for speech" so no clipping;
And I must admit that: nowadays, there are more physicians involved in
breastfeeding and human lactation, and thus you can see two types of
physicians, those who admit clearly the frenulum should be clipped, and
those who are "for" the breastfeeding but who don't see why clipping the
frenulum would bring something to the latch.
I had a good deal with an OT next to my town: if I "feel" the latch is not
good and I "feel" it could maybe come from tongue-tie, I refer the mom/baby
to him, and he will examine the baby and maybe.... (note we have very good
relationships, so I could ask him like noted above).
I was happy to find the "Frenulotomy for breastfeeding infants with
ankyloglossia: effect on milk removal and sucking mechanism as imaged by
ultrasound". Pediatrics. 2008;122:e188-e194.
It could help a lot!
Breast regards,
Françoise
----- Original Message -----
From: "Winnie Mading" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, February 25, 2009 2:08 PM
Subject: why some docs refuse to treat tt
Alison Jacobson asks:
1. What are the skeptical physicians' reasons for doubting that tongue ties
can affect nursing success?
I think this is most common in older docs. As I understand it, ties were at
one time always clipped "to prevent speech problems". Coincidentally, at
about the same time that it was decided it wasn't always necessary for
speech, breastfeeding was at its lowest initiation rate. Not clipping then
became the norm and with breastfeeding rates being low, the connection
between tt and bf wasn't noted bexcept by a very few. Later as we know,
breastfeeding rates increased, and in time the potential problems tt caused
in breastfeeding was realized initially by the strongest bf supporters and
as time went on by nearly all bf supporters. When many docs were asked
about clipping the frenulum, the typiical response was, "We don't do that
anymore." or "That really isn't necessary." Right along with "We've always
done it this way" which is one of the hardest "reasons" to fight.
Winnie Mading
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