Why NOT recommend frenotomy IF it is indicated?

In such cases - after thorough examination of tongue, its movement, with Hazelbaker Screening tool AND additionally with photos and videos, weight gain, milk supply, pain of the mother - I have very good experiences with frenotomy and further follow up combined with thorough breastfeeding counselling, sometimes with at-breast supplementation, especially with the posterior type of tongue tie which is mostly not recognized.

The good experiences are for example:

The pain disappears.
The weight gain is going upwards (also in case of bottle feeding)
The mother continues to breastfeed while she was near to weaning.
The mother is able to breastfeed directly, after having bottle fed 100% breastmilk.
The breastfeeding frequency is reduced from 16 times per day to 9 times per day - with adequate weight gain and the baby is satisfied after feedings, and parents relax.

The bad experiences if frenotomy is NOT done (for example because the parents don't want it) are:

Premature weaning
Continuing pain
Continuing Supplementation / Bottle feeding

I have picked up that there might have been a kind of overdoing frenotomy in the USA. This is definitely not the case in Germany. In my private practice I am specialized on low milk supply, low weight gain, relactation and at-breast Supplementation. Not recognized tongue-tie is one of the most common reasons for these issues amongst the mothers I councel (who are obviously NOT representative for the whole population).

Márta Guóth-Gumberger, IBCLC
Rosenheim, Germany
www.breastfeeding-support.de
email: [log in to unmask]

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