The Am. Acad of Pediatrics Summer 2004 issue of their Breastfeeding Newsletter was primarily devoted to tongue tie, with excellent info and illustrations. (the same issue was promoting the now-defunct US ad campaign - too bad!).  I got to it somehow through www.aap.org although I don't remember which links I took.  The Academy of Breastfeeding Medicine also has a protocol for ankyloglossia, but I confess I was a little bothered at the lack of reference to IBCLC's for support, and in that it seemed as though if a physician reading the protocol wasn't already on board, he/she would be unlikely to be convinced of it's importance to BF.  It seemed a little like giving lip service to the issue.   Anyway, two sites with good stuff. 

 Personally, I think the sooner the better.  Get an eval from an ENT familiar with breastfeeding if you can't find a peds who will do it.  Or an orthodontist.  It is such a simple process the baby is more upset about being held still than about the actual procedure.  Sooner (within a couple weeks rather than a couple months) also usually means the tissue is not vascularized, more like snipping the layer of skin that peels off a blister.  Funny how we (some folks) don't blink an eye about circumcision (for non-religious reasons) but think this is intrusive.  

Best wishes on this one.  I've gone recently from working where we had staff peds who would come do it on day 2 (and affiliated ENTs who would come in if needed) to a place where the doc laid out the BF nazi terminology to the mom about our recommendation that she be referred for eval and probably clip, and convinced her that she didn't need to pump because the baby was "going to the breast."  Of course, he had no clue that the baby was NOT latching, just chewing the nipple, NOT transferring milk, and NOT building mom's supply.  He also didn't have (or probably care about) the mom's sore nipples.  He remains convinced that it's not important to BF because he has only seen 1 or 2 clips in his other (abysmally non-friendly) hospital.  Mountains to be climbed with this one (thankfully my other docs are more receptive to my expertise).

Seems like we should have this issue behind us, but I guess not...
--
Kay McKee

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