Pamela, from my perspective, there are two important things going on with
the AHRQ article:
- Evaluation of results: there is great confusion about whether
frenotomy is necessary vs. sufficient. I am seeing a lot of babies who need
a frenotomy, then need a lot of physical therapy of SOME kind (CST, MFR, or
whatever the available modality to reorient muscles and fascia to what they
can do after release of ties) to reach full range of motion. This should
not be a surprise -- nobody gets a knee replacement and expects a magic
wand to make them ready to walk well. (And most of my friends who have had
knee surgery have a love-hate relationship with their physical therapist.)
- Function: If LACTNET members are ready to think of breastfeeding as an
infant vital sign, when will this concept get imparted to the many kinds of
health care providers who address oral function through the life span? The
AHRQ article looks at tongue tie from a very isolated perspective. Can we
get studies, in the internet age, that will follow the observations of all
types of clinicians about a child's feeding, speaking, breathing, and oral
health throughout development? There are so many remarkable stories out
there of families where remedy of ties interfering with an infant's feeding
led to decisions for tongue tie release of siblings and parents, which led
to remarkable improvements in various problems due to better eating,
sleeping, breathing, posture, etc. How can we account for these decisions
more systematically? Function is so much more than the infant growth curve
or even mother's comfort!
Ruth
--
Ruth Piatak, BA, MS, LLLL, IBCLC
Tulsa, Oklahoma
214-886-1218
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