Rene writes:
A few weeks back I did mention the possibility of a TT, and she did ask -
I believe her pediatrician - but the idea was dismissed. I am not qualified
to evaluate for TT, myself, as I have no experience with them, so can
neither argue nor confirm the diagnosis.
~~~
Ah well, consider this: most of the MDs who are also not qualified to
evaluate for tongue function do so all the time, declaring that of course there
is no such thing as a posterior tongue tie anyway, and if there was, there
is nothing safe or effective to be done about it. That said, you can be
very descriptive about what tongues can usually do, what they need to do for
breastfeeding to be efficient and comfortable, and what this baby's tongue
cannot do: lift, or lift without being distorted to a more pointed shape,
lateralize, extend over the gumline with the mouth wide open, cup/groove,
etc. Since I know full well that when moms attend certain pediatric practices
they will be told most definitely that my assessment of the baby's tongue
issue is wrong, I just continue to be descriptive and point out the
functional implications I see that make sense with that assessment. I might show
the parents the 2004 AAP article by Coryllos and Genna, or Dr. Kotlow's
parent booklet on his website, or review the mom and baby functional measures (
mom's pain, baby's lack of certain movements or strength, etc.) from the
Pediatrics article that came out a year or so ago. I might do all of them.
The doc will still say I am wrong, and there is no such thing, but moms can
still come around to seeing what the evidence shows (or not.) They can talk
to other moms whose babies have been helped by having an evaluation done
by a local ENT who has become an expert. They might be able to talk to other
moms whose babies have been down this road too. Back in 2004 when I was
blown away by this new information and got to hear Dr. Coryllos and Cathy
Genna speak on it for the first time, I also figured I didn't know how to
evaluate. Even now I second guess myself constantly due to local ignorance that
keeps too many moms from getting help, but I always remember one thing Dr.
Coryllos used to say: "If it looks like a duck and quacks like a duck,
it's probably a duck." Translation: if the tongue looks like a tongue that has
a restriction, and acts like a tongue that has a restriction, it probably
has a restriction. Now in this baby's case the jaw asymmetry could be part
or all of the explanation for why this is so hard, yes. But you can just
look, and watch, and challenge the baby to do what you know he/she should be
able to, and tell the mom what you are seeing and what it might mean. You
can do it...:)
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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