Dear Hadassah,

As IBCLCs it is not within our scope of practice to diagnose, only to share what we observe and offer ways to address the situation. My approach with tongue-tie or lip-tie has always been to point out to the parents how there is this thin piece of tissue that seems to be keeping the tongue or lip from moving easily, offer printed information about tongue-tie (Lactation Education Resources has an excellent handout with photos and a list of "symptoms" that indicate how tongue-tie can impact more than breastfeeding), and suggest that if they want more information they consult with a pediatric ENT.

Cindy Garrison BS IBCLC

> Date:    Wed, 19 Feb 2020 22:18:42 -0500
> From:    Hadassah Mann <[log in to unmask]>
> Subject: tongue tied-or not?
> 
> how do those of you in private practice approach a situation where you see a baby that is clearly tied, but you can tell the parents don't want to hear that? If it was something that was 100% medically agreed on, obviously I would say something, but with all the controversy with tongue tie, I don't feel that I am holding back any info if I don't. I will say there there seems to be some restriction and offer exercises to improve, but am apprehensive to suggest that baby is tied if it is clear that they are not interested. At the same time, I wouldn't want them to hear from someone later down the line that they are tied and then question why I didn't say anything. Your thoughts?
> 
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