Here is an example copy of the letter I developed for parents to take
to their doctor/midwife explaining the need for dealing with a tongue
tie. So far I have had positive feedback from healthcare providers
who have received my letter.
To whom it may concern,
BABY was born at home after an uncomplicated vaginal delivery 19 hours
prior to my initial visit. He weighed 8lbs 8oz (3900g) at birth. He
had been feeding frequently as expected. MOTHER described his latch
as pinching.
BABY was finishing a feed when I arrived and he fell into his first
deep sleep since being born. I did manage to get a quick look in his
mouth and it appears that he likely has a type 3 or 4 tongue tie.
After discussing with MOTHER her breastfeeding issues with her older
daughter I think it is likely that she too had a tongue tie which
affected her ability to breastfeed efficiently.
While initially it appeared that BABY could extend his tongue past his
gums and to the roof of his mouth when his mouth was only partially
open, it became apparent that when BABY opened his mouth wide (as he
needs to in order to latch and breastfeed effectively) he is unable to
raise his tongue normally, nor is he able to lateralise his tongue.
BABY is showing symptoms consistent with a Type 3 or Type 4
tongue-tie. I recommended that MOTHER have BABY'S tongue evaluated by
an ENT or other physician familiar with ankyloglossia and breastfeeding.
MOTHER'S nipples are showing signs of Stage II nipple damage from BABY
being unable to form a deep latch on MOTHER'S breast.
In my experience, even if a baby is gaining well in the initial months
due to the mother’s abundant milk supply and strong let down, the
mother’s body is not getting the appropriate nerve signalling to the
brain due to their infant’s poor latching and suckling to continue
copious milk production. At around the three month mark these mother
/ baby couplets can develop milk supply issues when the mother’s body
ramps down milk production to meet the perceived demand signalled to
the mother from the baby’s suckling. Galactopoesis is based not only
on quantity of suckling but also the quality of the suckling.
Tania
Ontario, Canada
--
Tania Archbold BSc, IBCLC
Mother's Nectar Lactation Consultant Services
www.mothersnectar.ca
Quoting Jennifer Welch <[log in to unmask]>:
> Personally, this is a conversation I would love to see remain
> public. This is an issue that I struggle with too, and I am sure
> there are many others too. I think we could all benefit from
> hearing how others approach this subject with parents an physicians.
>
> I once had a client with nipples that looked like hamburger meat.
> Baby had an obvious tongue-tie, but was gaining well thanks to
> catching mom's fast MER & massive oversupply. Baby's doctor
> acknowledged the TT, but said it was not affecting BFing because
> baby was gaining well. I sent them to a local clinic who does
> frenectomies and the issue resolved. But I would have liked to do
> more than that. I would have loved to discuss the issue with the
> 1st doctor, in hopes helping him understand that BFing is a 2-way
> street. If mom cannot stand to put babe to breast, it doesn't
> really matter if he can catch her milk well enough to gain or not
> because it isn't going to last.
>
> I have grown professionally since then, and now would have handled
> it differently, but I was a bit chicken then, quite intimidated by
> dealing with the doctor. I know I am not alone in this area and I
> think we could all benefit from a discussion on this.
>
> Jennifer Welch, IBCLC (2010), LLLL (2006)
> Montreal, Quebec, Canada
>
> (This happened just 8 months ago, when I first started practicing.
> I am still a "baby" LC, but the learning curve in those first few
> months has been steep!)
>
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