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Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 2 Apr 1998 15:57:08 -0600
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I have a tongue-tie story.  I saw a mom and baby on March 25 with a problem
of baby feeding for only a short time and coming on and off and crying.  I
first suspected a food sensitivity or over-supply, but baby was sleeping
very well at night and was just a little fussy in the evenings.  Mom had
been pumping for 3 months and giving milk in a bottle.

When I arrived, a very healthy baby awoke and began to cry, revealing a
frenulum attached to the tip of her tongue, creating the heart-shaped tip.
I said, "She is tongue-tied."  Mom said that the LC in the hospital after
the birth had recommended that it be clipped but that the Ped said it
wasn't necessary.  He had done a study in Med school on the effect of short
frenulum on breastfeeding and it showed that there was no negative effect.

We talked about the obvious effect this baby's tongue tie was having on her
ability to maintain an adequate latch for a whole feeding, and I shared
some of the other reasons to have it clipped.  Dad was in favor of having
it clipped because he had a friend in high school who had been most ashamed
of his tongue tie.

They made an appointment with the ENT specialist who does most of the
frenotomies for my clients. I did contact the Ped's office to apprise them
of the situation.

The clipping was more extensive than most that I have seen done. (I usually
accompany the parents to the office because they are nervous and they ask
me to go to hold the baby and lend support.) I assume that since it was
attached to the tip, there was more tissue to be clipped.

Since the baby hadn't been breastfeeding well, she wouldn't feed after the
procedure and did bleed more than usual.  She also cried harder, probably
adding to the bleeding.  This may be because she was older and "more
expressive." (?) Mom cried too and I complimented her for her empathy,
assuring her that her baby was lucky that Mom could share her pain. Dad was
comforting both of them.

They gave baby Tylenol that afternoon and evening.  Baby fed longer at the
breast at each feeding and by the next afternoon was taking the entire
feeding at the breast.  Mom, Dad, and baby are all very happy that the
frenulum was clipped and that feedings are now "pure joy."  The parents
plan to share this success story with the doctor in hopes that his policy
will change.

I believe that all would have gone smoother if the procedure had been done
early on.

I do hope that some good article on the advisability of clipping the tight
frenulum at birth will be in the good old Ped journal soon. I know that,
even then, it will take some time for this knowledge to trickle down, but
it could certainly help.

Patricia Gima, IBCLC
Milwaukee
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