I suspect are talking about diode lasers, which can be from 700 to 900
degrees the way they are used. A filament is put on the laser, and the
end is blocked by carbon, leading the laser energy to bounce back and
forth in the filament and heat it up. The hot filament is used to cut
the tissue.
Other lasers are actually used as lasers (the laser energy itself
vaporizes the tissue), and do not generate as much heat, especially if
used on low energy and intermittent (on-off-on-off) settings. Great
skill is needed for any surgical procedure, whatever the tool. I've seen
good and bad outcomes from every tool and technique. And of course, we
need to carefully distinguish babies who need a frenotomy from those
with other issues. We live and learn.
Catherine Watson Genna BS, IBCLC NYC www.cwgenna.com
On 10/21/2020 9:14 AM, Jan Barson wrote:
> I have been to a talk at one of our biggest maternity hospitals in Melbourne. That hospital recommends that laser should never be used on babies’ mouths They states that laser is basically extreme heat and can’t be controlled enough to prevent damage to deeper tissue layers . They had good evidence of nerve and muscle damage, excessive pain and trauma for both mother and baby . I know this is such a contentious issue but I found the presentation and discussion evidence based and compelling. I have also seen in my own practice a babies mouth horrendously damaged and a desperate mother told to stretch the wound several times a day. As an LC I would now never ever recommend laser frenotomy and suspect in the future it will viewed as abuse in much the same way as circumcision is view<https://aka.ms/o0ukef><https://aka.ms/o0ukef>
> ________________________________
> From: Jan Barson <[log in to unmask]>
> Sent: Tuesday, October 20, 2020 7:34:12 AM
> To: Lactation Information and Discussion <[log in to unmask]>
> Subject: Re: LACTNET Digest - 11 Oct 2020 to 12 Oct 2020 (#2020-174)
>
> I have been to a talk at one of our biggest maternity hospitals in Melbourne. That hospital recommends that laser should never be used on babies’ mouths They states that laser is basically extreme heat and can’t be controlled enough to prevent damage to deeper tissue layers . They had good evidence of nerve and muscle damage, excessive pain and trauma for both mother and baby . I know this is such a contentious issue but I found the presentation and discussion evidence based and compelling. As an LC I would now never ever recommend laser frenotomy and suspect in the future it will viewed as abuse in much the same way as circumcision is viewed today.
>
> Get Outlook for iOS<https://aka.ms/o0ukef>
> ________________________________
> From: Lactation Information and Discussion <[log in to unmask]> on behalf of LACTNET automatic digest system <[log in to unmask]>
> Sent: Tuesday, October 13, 2020 3:00:09 PM
> To: [log in to unmask] <[log in to unmask]>
> Subject: LACTNET Digest - 11 Oct 2020 to 12 Oct 2020 (#2020-174)
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> There is 1 message totaling 53 lines in this issue.
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> Topics of the day:
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> 1. Fwd: treating a posterior tongue tie in Monsey NY
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> Date: Mon, 12 Oct 2020 16:45:24 +0300
> From: Fogelmans <[log in to unmask]>
> Subject: Fwd: treating a posterior tongue tie in Monsey NY
>
> ---------- Forwarded message ---------
> From: Fogelmans <[log in to unmask]>
> Date: Mon, Oct 12, 2020 at 3:45 PM
> Subject: treating a posterior tongue tie in Monsey NY
> To: <[log in to unmask]>
>
>
> Dear Friends,
> A young relative just called me from Monsey New York and needs help.
> She is a first time mother and is having problems breastfeeding - pinched
> nipples, baby isn't transferring milk and supply is down, baby clicking at
> breast and frustrated... Baby is 6 weeks old. She met privately with an LC
> twice. The LC said that the baby has a posterior tongue tie and a lip tie
> and recommended frenotomy and body work. She has an appointment for the
> frenotomy but has some questions. Permission to post.
> First of all she was led to believe that the procedure must be done by
> laser in order to get good results. This is not my experience here in
> Israel. What do you think (the laser is very expensive for this young
> couple)
> She also believes that almost all problems caused by a posterior tongue tie
> will resolve themselves naturally by 3 months. She understands that she
> would be pumping during this time to keep up her supply and keep the baby
> fed. But I am not confident that there will be an automatic improvement at
> 3 months.
> Lastly, her pediatrician has told her that fixing posterior tongue ties
> seldom makes a difference.
>
> I would really appreciate your advice and for those of you from the area,
> a recommendation for a doctor in Monsey that does posterior frenotomies and
> preferably takes Medicaid Fidelis.
>
> Thank you so much,
> Chayn Fogelman Israel
>
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> ------------------------------
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> End of LACTNET Digest - 11 Oct 2020 to 12 Oct 2020 (#2020-174)
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