Subject - Dr. Brian Palmer Some recommendations on frenums.
I have read some of the notes regarding your frustration about frenotomies
and frenectomies.
The biggest challenge is that the significance of tight frenums on
breastfeeding is not taught in medical or dental schools. Probably very
little is even taught about the importance of breastfeeding. Curriculums
are based mainly on treating disease and not prevention. There is very
little money to be made in prevention so it does not get a high priority.
Patients and insurance companies usually do not like to pay for prevention,
but are willing to pay after damage has occurred. This does not make sense
to me, but that is the system.
As mentioned in most of the notes, the liability of anyone doing the
procedure in the US other than a doctor is a problem. Our society is too
litigious. One bad outcome which is very, very rare - even after 300
great outcomes is not worth the frustration, so many doctors just will not
do the procedure.
I was very fortunate during my 35 years in practice. I had a friend who was
an excellent oral surgeon whose mother (now retired) was a pediatrician and
who routinely did frenotomies in her office. My friend knew all about
frenums and did them for me, and also went to the birthing center at the
hospital to do them there.
My recommendation is to have an organization like ILCA, LLLI, or a large
hospital complex, set up a website listing all the doctors around the US
and other countries as well - who are willing to do the procedure. A great
example is the UNICEF site of frenums treatment centers in the United
Kingdom where parents can go to have the procedure done. The link to that
site is - www.babyfriendly.org.uk/tonguetie.asp
<http://www.babyfriendly.org.uk/tonguetie.asp> My website links to their
site, and they link back to my website. When I get emails from Europe
wanting help with frenums, I usually refer them to that site. I correspond
occasionally with Carolyn Westcott who works with Dr. Mervyn Griffiths.
They do a lot of procedures. I presented in Australia last year with Monica
Hogan who used to be part of that team. She now lives in Sydney a
connection for those in Australia. Dr, Paul Johnson in Oxford, England is
also happy to do frenums surgeries. LCs are doing the procedure in the UK
and may be starting to do them in Australia.
I know that Catherine Watson Genna (NY) and Carole Dobrich (Quebec) are
doing some great research in the area. Once they, and others, have
published their articles on the topic, doctors will have a better
understanding of the procedure and will be more willing to do them.
I do recommend you download the frenums presentations from my website and
give them to your local doctors. Hopefully the presentations will give them
more information than they have ever had and then they will hopefully be
more open about doing the surgeries.
I also recommend that you spend some time learning about sleep apnea. Some
basic information on the topic and articles I have authored are on my
website. I am slowly educating sleep doctors, dentist and hygienists about
the importance of breastfeeding as a way to reduce the risk of sleep apnea.
It is now the responsibility of the lactation community to learn about sleep
apnea so when doctors ask you about how the physical act of breastfeeding
can reduce the risk of sleep apnea, you can respond with an educated
response. Consequences of sleep apnea are having a major financial impact
on the general public and our health care system. As this problem becomes
more apparent, people will be looking for healthier alternatives.
Breastfeeding will be the best option! It is just like the frenums issue
all sides have to be educated about the issue.
You have my permission to share this note and the note about my position on
the Pacifier-SIDS issue with others.
Brian Palmer, DDS (Retired)
You can always contact me through the Comment Page on my website at
www.brianpalmerdds.com <http://www.brianpalmerdds.com>
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