Babies usually do figure out a way to breastfeed with tongue tie, but 
they might not get enough milk and the milk supply dwindles and/or they 
may continue hurting mom for many months (I've had moms of 8, 9, 10 
month old babies come with continued pain). I agree with Kathy Leeper 
that many tt babies can breastfeed acceptably between 6 and 12 weeks of 
age. BUT the continued abnormal tongue movements are a poor basis for 
future tongue function, and do not shape the mouth and palate properly 
either.

Moms play into the equation as well. It's easier for a tt baby if mom 
has elastic breasts and everted nipples. And if mom allows the baby to 
bf longer and more frequently than the average baby, they are more 
likely to get sufficient milk.

Sometimes tongue exercises help. But frenotomy almost always helps, and 
is such a simple procedure. Human beings have been modifying this 
genetic trait for at least 8000 years (earliest written mentionm of 
newborn frenotomy is in a 6000 BC Chinese medical text), so natural 
selection has been pre-empted.
Catherine Watson Genna, IBCLC  NYC

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