The fact that the tongue tie has been clipped is no guarantee that the baby will
now latch and feed well. I think that this takes much longer than is generally
assumed.

 I usually try to get the baby to latch soon after clipping and you can
usually see how the baby probes with the tongue and becomes frustrated because
there is a change. The baby attempts to feed in the familiar way and needs to 
establish a new motor pattern,  so there is learning involved.

This is true for both bottle and breast.  I think it can take weeks
for the tongue to reach it's full potential when clipped. One good latch and the baby
is usually away, but if the "easier" bottle is competing with the breast this may never
happen. The baby needs to find her way on the breast. 

This is a case where cup feeding as supplementary feeder may be a better option than a bottle
as the motor pattern on the cup is very different, but at least you can feed the baby until she 
works out what she needs to do on the breast. 

The tongue needs to be used now to establish the pattern. I have seen a baby with severe
tongue tie go from aspirating milk soon after clipping but becoming better and better
at manipulating the milk in the mouth to the point of no aspiration.  

The instances where clipping is the "magic wand" are the exceptions and I think we should inform 
mothers that full establishment of feeding is usually a few weeks off.

Loraine Hamm
Speech Language Therapist, IBCLC
New Zealand

 
     

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