Cathy WG writes:
If we use good pain relief during and after the procedure, there's less
risk of adverse neurological consequences.
~~~
This is one very variable area, I find. Lots of variation in pain relief,
practice of how to visualize and assess the area, how the baby is held and
by whom, instrument doing the release, what practitioners are wearing
professionally, post-release assessment, chagne to breastfeed in the
office
before leaving, home pain relief, and post aftercare are all variable by
a
lot. One local ENT uses no pain relief before or after. I've seen babies
actually sleep through the release she's so fast and smooth. She now
recommends
post-release stretching for all babies. Another one uses swabs with pain
reliever before each procedure, then cauterizes with Silver Nitrate sticks
after, but suggests no pain relief after and recommends no stretching.
Another uses no pain relief, and recommends no exercises. ( The second
two also
do only anterior releases.) It seems like it's all so new that
professionals are trying to find their own way. Since 2004, there has been
so much
change ( 2204: When Dr. Elizabeth Coryllos, Catherine Watson Genna and
someone
I admit I cannot remember, had that seminal article in the Summer AAP
newsletter for the Breastfeeding Section. )
It's always a challenge being on the edge of new or newish information. We
still have quite a few busy IBCLCs who do not assess for or make
suggestions concerning tongue-ties that are anything but the heart-shaped
ones at the
tip. So much to learn and be learned.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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