I had great success once I set up a good relationship with an MD in Puerto
Rico - we were having about one baby a week in our clinic (remember people
came who had problems - I didn't see "normal").
His quick intervention helped a lot, as moms would not suffer from sore
nipples and low milk supply.
Now I go out with the Public Health Nurses and mom may not be having
problems - I'm there to teach the PHNs some basic interventions and
assessments so they know when to send moms to me. In the last year I've
had two moms whose babies were VERY tongue-tied - but moms had no soreness,
and babies gained great. In fact, today I was re-visiting a mom I had seen
at 4 days and I had asked the PHN to watch weight, pain, etc. as I had seen
a tongue tie. However, during that visit we were able to observe a good
latch and hear good milk transfer, and mom said she had no pain. WIC
re-referred her now because she reported some problems with latch-on. Baby
is now 6 weeks and has gained 2 lbs.
Well, the latch on problem turned out to be a VERY strong let-down. Mom
was concerned because he let go 3-5 minutes into the feed. I watched the
strong milk flow occur, then baby went back again - no pain, obviously
plenty of gain. Other than a spray of milk all over the place, no real
problem. Mom was very pleased to learn the reason for the baby's
behavior. This baby, once he is old enough to cope with the let-down,
will probably be one of those that feeds for only 5 minutes by the time he
is 3 months old.
So, I'm finding that IF there is a good "fit" between mom and baby, the
clipping may not be needed. However, I still wonder about speech problems
later. One of our Health Aides has a child who is tongue tied and even
with much speech therapy he still has problems and kids tease him. She now
wishes she had known about the surgery.
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
mailto:[log in to unmask]
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