33 years ago, we would check the girl babies in the delivery room and if they were tongue tied, the doctor came over and clipped it before he/she left the room.  The boys were checked at the circumcision and clipped then.  No permits for the tongue clipping, no discussion with the parents..just did it.  Amazing what we got away with back then. I also worked with a doctor who did swipe under the tongue with his finger nail on tongue ties.  I never saw it but not sure I would have wanted to. Currently our ENT will come as soon as he gets a referral to clip a tongue, but lots of docs who want to "wait and see" even if there is evidence of poor feeding and nipple damage. Sorry, no protocol here.  There never seemed to be a problems with those early tongue clippings and may have saved a lot of frustration and pain. 
Sue 
 

Susan Gehrman RN, IBCLC, CCE
Battle Creek Health System
300 North Ave.
Battle Creek, Michigan 49016
Phone: 269-966-8586

Breastfeeding... A natural resource. 

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>>> g raphael <[log in to unmask]> 02/19/2009 3:31 PM >>>
ok, so i was at synagogue on saturday and there were three breastfeeding mothers there (in the creche) and all were struggling with getting their baby to latch... but were breastfeeding (although one mother was topping up as she said she could not keep her milk supply up b/c her daughter was v fussy at breast.... on further inspection... ALL three babies were tongue-tied.  The majority of babies I see whose mother's are complaining of sore nipples, low milk supply or 24 hour nursing are tongue tied.   I see so many TT babies these days that my main job seems to be faxing ped surgeons for speedy frenulotomies.  I spoke to a ped surgeon's secretary the other day who says that the surgeon started his clinic estimating that he'd get 4 TT babies a week, he's getting 20 babies a week running two clinics and there's still a waiting list.  

Now there's the legend that midwives used to just cut the TT with their fingernail at birth.  Now I'm wondering if you think if a ped surgeon or trained LC/midwife etc should be available at birth for any baby with TT... would it be worth implementing in BabyFriendly hospitals?  Are there risks in dividing a TT baby's tongue this early?  To catch a mom on DAY 4 or worse yet on DAY 12 when milk supply has been compromised, baby's been screaming and losing weight (and possibly been exposed to formula milk), and mother is a wreck.. is this a necessary exercise..??  I can't even believe that BF hospitals can send mother home without witnessing any milk transfer.  

So a senior midwife at my local hospital is intrigued.  Is it worth following up?  IS anyone out there already have TT-division protocol on day 1-3 at their hospital?



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