When Jennifer was posting about tongue ties and all, I was thinking that a 
big part of the problem is that pediatricians just don't want to 
acknowledge that a tongue tie CAN (and often does) impede a good latch. 
They just are not trained in that at all and I think it bugs the heck out 
of some of them that we LC's do see, recognize and refer for frenotomy. 
They just do not have much background in this.

We used to have far more trouble with that than we do now. Our community 
pediatricians no longer come to the hospital (most of them, that is) and 
our hospitalists do the initial evaluations instead (although we did have 
to get one of the hospitalists to believe a need existed as well). We also 
have more time to speak with the parents and do some teaching about this. 
We also have a wondeful ENT who will come over quickly and do a clip when 
we see the need. Her office is within walking distance.

My favorite scenario happened many months ago. I happened into the nursery 
one afternoon (at change of shift) as a baby was having an assessment. Dad 
was standing right there and I commented on a significant tongue tie that 
I could see easily. He told me I was the third nurse who had mentioned it 
(I immediately thought good for those other two nurses who mentioned it 
first). I questioned dad about Mom's comfort with baby at breast and he 
went on to say that she was sore, etc. The hospitalist (who needed to 
learn) was right there and of course (to my astonishment) poo-pooed the 
idea of a tongue tie. Their regular pediatrican (one who still comes to 
the hospital) had also downplayed the problem, according to what Dad told 
me right then and there. I continued with what I was saying to Dad (in 
front of the doc (thank goodness she was listening) and showed him . Long 
story short, the ENT was called and the tongue toe was clipped that same 
afternoon. Everything was so much better after that.

We LC's just have to keep on truckin' as far as teaching parents and 
docs.WE do make headway, as difficult as that is to believe sometimes!
Betsy Riedel RNC, IBCLC
Connecticut

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