Dear Dr. Shaw,
There is a wonderful pediatric ENT in Austin with whom I often collaborate
when I see newborns with tongue-tie.  He has followed 25 such babies in an
observational study which he presented as a poster presentation at the June
1997 Pedi ENT annual meeting.  Breastfeeding was going poorly with all the
presenting dyads.  Mom had sore nipples, or baby was breast refusing or
gaining poorly.  Various problems in various combinations.  He evaluated
these babies and performed lyssis in his office.  No complications or bad
outcomes.  A statistically significant number of the babies improved in
terms of better weight gain, improved sensation for mothers. I edited his ms
and am encouraging him to publish. He values breastfeeding because he feels
it prevents so much tx for chronic middle ear infection.  Because of his
respect for bfg he was willing to consider that restriction of the range of
motion of the tongue might just have the kind of impact on feeding that
webbing between the fingers might have on manual dexterity. I send him a lot
of babies and he evaluates each individually -- as should always be the
case.  Some he clips, some he doesn't.  I have good success with positioning
alterations to help get babies closer to breast, and sometimes this is all
that is needed.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html