Hi All,

 

I didn't realize I'd start such a thread but since it happened I'd like to
comment on some of what has been said.  :-)

 

I completely understand why we should wait, for now, on IBCLC's doing
frenotomies.  Even tho a frenotomy is not a big deal in reality it is still
considered a surgical procedure.  Someone mentioned a Frenectomy - this is a
totally different procedure that involves suturing the underside of the
tongue and requires a general anesthesia.  A frenotomy is simply clipping
the frenulum - maybe a drop or two of blood - babies tend to hate them only
because they are swaddled tightly and held very still with their mouths
opened up whether they want to or not.  My understanding (from my reading
and watching and talking to ENT's here who have done frenotomies in the
past) is that the frenulum webbing does not have nerves so does not hurt.  A
topical anesthetic is used as a precaution, just in case.  :-)  It really is
a simple procedure.

 

At any rate, with our ridiculously litigious society it would not be prudent
for IBCLC's to try to get a license of some sort to do simple frenotomies.
Sad but true.  I just wish that it were possible for us to do so and do so
in a manner that made sense.  A TT that could be clipped (at the consult) in
a second and save days of pain and frustration would be a blessing for all.
I have had many parents ask if I could do it!  All were frustrated when I
told them no.  One dad even said 'It's not like you're doing a
circumcision.'.  :-)  

 

I do not recall anyone implying that anyone else had said that they tell
moms their Doc is an idiot.  However, I must admit that when my client told
me what this young ENT said - I couldn't help myself.  Blame the bad
headache I had but I said, "If this guy said your baby has no frenulum and
there isn't anything there to clip he doesn't know what he's talking about!"
Luckily, with her it was not a big deal because she agreed wholeheartedly
(she could certainly see her baby's frenulum.).

 

Bottom line here, we (sadly) have to sometimes "Play the Game" in order to
help our clients.  I have a new item on my list of things to do this week
(as if it isn't already long enough) - call around to the many pediodontists
and dentists to find out who does frenotomies.  I thought it was interesting
that my own child's pediodontist would do a frenectomy but not a frenotomy.
Go figure.

 

At any rate, the discussion has been very interesting to read and has
brought up some real things to think about.  It is possible that, in the
future, our scope of practice will expand.  In time IBCLC's will be the true
gold standard of Breastfeeding Care and the general public will know that
there is a difference between a CLE, a LLLL and an IBCLC.  IBCLC will become
what you are required to have to call yourself a Lactation Consultant (no
more CLC).  We will actually have some true consistent value.  When that
happens, those of us who have different specialties in this field will be
able to become more valuable - this IBCLC is licensed for clipping frenulums
- this IBCLC is the specialist in Clefts, this IBCLC is the specialist in
babies with serious suck issues - We will be able to become much more than
just breastfeeding help.  We will become true and valued allies in the
health care field and will be greatly respected and referred to regularly.
Someday..

 

Hope all are having a good weekend.

 

Jaye Simpson, IBCLC, CIIM

www.BreastfeedingNetwork.net <http://www.breastfeedingnetwork.net/> 

Sacramento, CA

 

 

 

 

 

 

 

 

 

 


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