I have it easier here, I refer to a pediatric surgeon, several ENT's,
and an oral surgeon for tongue tie.  I try to immunize the parents
against the controversy by explaining that the pedi might not know much
about this since bf was out of favor and so was frenotomy; then I write
in the physician report that "specialist evaluation of the lingual
frenulum is strongly advised, in light of the oral motor problems,
distortion of the palate, and (add whatever family history issues exist
here- hx of sleep apnea, speech articulation deficits, etc)".  By
positioning/reframing this as a specialist issue, it reduces the loss of
face on the part of the pediatrician who disbelieves that tongue tie is
an issue.

Fortunately, most of the peds are willing to give the parents a referral
by now, since they have been exposed to my reports for 10 years and are
starting to at least tolerate me!  Many will give the referral to which
ever practitioner mom chooses, some insist on referring to someone they
know (who might or might not have any knowlege of the subject), and a
few threaten the parents that they will "fire" them as patients if they
get any such thing done.  One of the threateners relented after the mom
took the baby for treatment anyway, but he had the mom in tears.  And
this was a baby whose father had just had his frenulum treated a few
months before her birth!
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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