I have some questions that I hope someone could help me answer.

If, as Catherine mentioned, posterior ties are qualitatively different, how accurate is the HATLFF for detecting posterior ties?   Also, what is your most definitive assessment criteria for PTT?  I usually put a lot of weight on how the tongue behaves when I press on the frenulum and how the tongue lifts when baby cries.

I am also having some trouble with the concept of "anterior spread."   How do others understand this particular criteria and how do you assess for it?  I have read the info at this (http://tonguetie.ballardscore.com/hazelbakerscore.htm) link but I am still not clear on this.

Also, how do you feel peristalsis?  I must have the most unsensitive fingers in the world because I cannot feel this!  I have had other LCs suggest to not use a glove but I am not comfortable with that for the baby's sake.  Does everyone else glove up or use finger cots?

Laura Spitzfaden, LLLL, IBCLC

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