In regards to pediatricians and ENTs questioning the need to have
tongue-tie evaluated:
 I have found it useful to let the ENTs (and probably would be a good idea
to include the pedi MDs on this, but haven't done so yet) know the results
of their work.  I never see the ENTs themselves in person.  So after a
frenotomy is done that has spectacular results, particularly with numbers, I
email the ENT and tell them " Thanks so much for seeing Baby X. This newborn
was not gaining weight and after the frenotomy, gained 8 oz in 2 days!
(frenotomy being the only change), and mother's nipples are healing. Parents
very pleased."  or some such brief follow-up report.  I heard back from one
of our ENTs how much difference that feedback made (an ENT that did them but
formerly didn't think it made much difference).
    Which makes sense to me; how many times do we give advice to someone we
don't see again and wonder if it made any difference. Knowing the results of
what one does definitely influences whether to do it again or not.
    Occasionally when a mother "makes it to the other side" and is
breastfeeding as she hoped to be after a stint of troubles, I'll ask her
what made it possible? The answers are illuminating to me.  (Most often the
answers in complicated cases are having been given realistic expectations
and on-going support, rather than a technique or a tool, even if I think
those interventions (supplementing, pumping, galactagogues, shields,
whatever) are what made it happen.)

Susan Lawrence

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