Dear Attie,
I agree. We need to make sure that our babies are being thoroughly
evaluated and helped with basic breastfeeding management (if there are
breastfeeding problems) with or without a possible tie. Sometimes even
with a tie, better latching and positioning can resolve the pain or milk
transfer issue. In many cases, having some body work done first, before
you try a revision can help resolve the problem. These are far less
invasive interventions.
I am very lucky that the pediatric dentist I refer to not only does a
great assessment but she really wants an IBCLC in place before the
revision so that there is good breastfeeding management before AND after
the revision. Sometimes a revision is like magic and all of a sudden
breastfeeding is so much better. Often it is part of the process and
change is happens more slowly. The dentist I refer to is very well
trained and can do the revision as gently and quickly as possible. I
trust her to make good decisions about my clients.
That being said, most of my babies, 95% or so off the top of my head, do
have a positive change with the revision. I honestly haven't had a baby
that the revision made breastfeeding worse in the long run. Sometimes
for a week or so, it can be worse, but then it gets better.
We also need more research as well on those babies, who don't get what
can be classified as a tongue tie revised when younger, and
breastfeeding problems later. Are there long term repercussions to not
having a tie resolves for later life? I worry there might be. I have
noticed that my friends that struggle with sleep apnea now are almost
all tongue tied! Could we avoid dental caries, orthodontic work, sleep
apnea, struggles with foods, later in life? I have no answer to this,
just one of my many questions.
I also have many babies that I would assess as having a possible tie
when they are 1-6 weeks old, don't get revised, and then come back to me
at 4-9 months and now the baby is having trouble with solids or starting
to refuse the breast. When they get the tie assessed by the pediatric
dentist and resolved, it helps with those issues as well.
I am lucky that I see a good number of my babies on an on-going basis
due to the support groups I run, and the revised babies do keep nursing.
But is that the revision or my support group? : )
We have far too many unknowns in our field due to the lack of research.
So, I think thorough, comprehensive, quality care is the answer.
Thank you!
--
Barbara Robertson, MA, IBCLC, RLC
The Breastfeeding Center of Ann Arbor
bfcaa.com
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