Yes---I think posterior tongue-ties are pretty common, and especially
prominent in a population of babies seeking help with breastfeeding.

As for what you can do to help without snipping...sounds like this
particular baby is refusing the breast because he has not ever succeeded
there, and does not believe there is milk.  One strategy is to use a nipple
shield to make it easier for the baby to "hang on" and more comfy for mom,
then have dad push milk through a feeding tube sitting inside of the shield
to convince the baby there is in fact food there.  Then you have to closely
evaluate whether the baby can remove any milk with the shield on his own.
He may not be able to if the posterior tie is keeping his toungue from
pushing up on the breast in the normal front-back wave.  In that case you
are left with a lot of work for the parents...pumping, supplementing (at the
breast as much as possible) and waiting.  Often these babies will grow large
enough in 6-8 weeks to get the milk on their own, but not many people can
stand to wait that long.

As an aside, I find these babies very frustrating, as a person in a position
to actually clip something.  But if everything else has been tried, I will
offer it to parents.  We are actually collecting data on various types of
tongue-ties and the effects of clipping them...hopefully can collect enough
info to get it written up by the end of the year.


Kathy Leeper, MD, IBCLC
Medical Director, MilkWorks

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