In a message dated 11/19/98 7:59:35 AM Eastern Standard Time,
[log in to unmask] writes:

<< CAUTION - I have seen babies with tight frenulums who breastfed without
 problems (perhaps mom's breasts were "made" to fit their babies better, o=
 r
 her milk supply was really great), and I have seen tongues which did not
 appear all that "tight" - but with moms having the typical line across th=
 e
 nipple and low milk supply, I have sent them to the oral surgeon, he has
 done frenotomies and their problems have been solved.  So in the hospital=
 ,
 I always tried correct positioning and careful latch on monitoring first =
 to
 see if things could be solved without medical interventions.   >>

Jeannette: I absolutely agree with you: A baby can have a short or tight
lingual frenulum and not be tongue-tied. We need to be careful about using
appearance as our major criterion. It is about function. If a baby's
tonguemotion is impaired becasue of a short and or tight lingfual frenulum,
then they are tongue-tied. The proverbial white stripe can be casued by many
other things than tongue-tie. the first management strategy should be deep
attachment but one can tell right away after correcting attachment if that is
not going to be enough so the first assessment which includes weliciting the
baby's best performance at breast while deeply attached will render lots of
data and certainly enough to determine if the frenulum needs clipped or not.

Alison K. Hazelbaker