I'm a little confused by Lea's post. Lea, can you please elucidate what upset you about the ENT?

Is it that the ENT did procedures that you thought was unnecessary?  Or that you thought the labial clipping was unnecessary?  Or that the ENT's bedside manner wasn't sufficient for the parents to be reassured that the procedure was necessary?  Or that the choice of mentioning a long term outcome such as speech issues was irrelevant?  or too long term? Or that the ENT should have mentioned the more immediate impact on breastfeeding?  Or that you were uncertain and think that if it didn't impact the breastfeeding, future speech problems could be dealt with later?

If you previously have had good results you might want to talk to this ENT.  I have had plenty of conversations with parents upset about frenotomies when they didn't produce immediate results -- even though I myself always warn them that the baby needed to get used to having more mobility. Sometimes parents will complain that a colleague might not have warned them.  I know many of my colleagues actually do have great bedside manner and try to be very reassuring, but parents will still blame someone when they don't get the instant cure they warn.  Sometimes they will say that the ENT didn't recommend the exercises to prevent the incision from readhering, but when I have talked with the ENT I refer to I have found that she always gives parents advice about that.  The procedure is scary for parents and we do need to work on helping them feel comfortable that they didn't subject their baby to an unnecessary procedure.  I think in talking with this ENT, you might be able to come to a better understanding.  

I mention this because I have heard reports from some of the clients in my group and an ENT that a few colleagues are telling parents that the ENT is not cutting deeply enough and blaming the ENT when the breastfeeding problems don't resolve quickly.  The ENT reports that the cutting is all the way to the muscle and cutting further would damage muscle tissue and nerves.  We did have a conference on Infant Oral Anatomy in the fall of 2009 with two ENTs, a Doctor of Osteopathy who of course does craniosacral work, a pediatrician IBCLC, a pediatric dentist and a speech-language pathologist. Now the ENT is thinking of holding a more in depth workshop sometime in the future to continue to promote dialogue between IBCLCs and those that do the procedures.  I think dialogue across professions is crucial. 

Best regards, Susan Burger, MHS, PhD, IBCLC

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