Hello Lactnetters,
I watched the GOLD conference recently and ended up more confused than ever regarding lingual function and the need for frenotomy. Dr Ghaheri referenced ultrasound videos from the 2008 Geddes study which showed the middle of the tongue rising then dropping to create vacuum for milk removal.  He pointed out how the anterior portion of the tongue barely moved during this process and that there needed to be complete release of the posterior frenulum in order for the mid-tongue to elevate. 

When I watched the videos it looked like the mid-tongue lifted by its own internal expansion not by the tongue elevating off the floor of the mouth. If the tongue truly lifted off the floor of the mouth I could understand the need for a posterior release, but since the underside of the tongue seemed to remain on the floor of the mouth during sucking, why is a posterior release needed ? Make sense?  What don't I understand? 

Also,is anyone aware of any videos of lingual function that could be used to compare pre and post-frenotomy function?  I couldn't find any. 

Thanks again for any insights.  I truly appreciate the ongoing sharing of knowledge that Lactnet has provided me over the years!! 

Sincerely,
Amy

Amy Wagner, BS, RN,CCES, IBCLC
Hershey, Pa

Sent from my iPad
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