Dear All,

I live in Tokyo and I have worked with mothers from different Asian
countries including .  I agree that we need to be sensitive to cultural
differences. But as others have said, more eloquently than I- We can't
decide for the mother what she wants to do.

Barbara Wilson Clay mentioned that the ENT literature shows a higher
prevalence of tongue tie in Japan then elsewhere. Tongue tie is a very
complicated topic here.

There are some schools of thinking which feel that -all babies- should
have the lingual and labial frenulum clipped.
Others feel that if there is any kind of breastfeeding problem, (poor
transfer pain in nipples) its probably related to tongue tie and should
be clipped.
These are just very brief and large generalizations, but I wanted to
give just a little background information.

Indeed there is a higher prevalence of clipping here then elsewhere. But
whether that increased frequency represents a true structural difference
for people of Japanese ancestry which increases the likelihood of tongue
tie, or whether it is a common cultural practice to simply expect to do
this as part of  routine newborn care is a question to keep in mind.

The guidelines being used to assess whether a tongue that "needs" to be
clipped are something to keep in mind also. Many Japanese IBCLCs that I
have spoken with feel the prevalence is related more to cultural
practices then to a true need for the clipping. This issue which is very
charged and sensitive topic in Japan.

Take Care,
Aileen Emerling IBCLC
Tokyo Japan

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