Hi Lisa,
I just did a search for 'ankyloglossia' on MSN search engine. I clicked on
about 5 websites and one said something like absolutely never do
frenuloplasty before age 4, another said it definitley affects bf, one siad
treatment is surgical correction, another said most can be managed w/
parental education and reassurance. So I am not surprised the mindset of
some is still not to clip. Since we (LCs) basically "live and breathe" bf,
of course we see correction as being necessary in alot of cases. In other
words if the bf is not perfect, we want it corrected. I just had a
mother/baby on Wednesday with this problem. The ped seemed fairly open
minded about it but wants a 'wait and see' approach and it was decided they
would wait til the milk was in to see if things improved. The baby could
latch, the mother had excellent anatomy, no pain or trauma, but no MER nor
nutritive suck by 48 hrs postpartum, even w/ ample colostrum hand expressed.
We went to pumping and feeding w/ tube at breast and bottle supps if needed.
You have done all you can for your clients. The ball is in their court, it
is their decision to make. I know if it was me and my baby I would go to the
'four corners of the earth' to get it corrected. But bf was an extremely
high priority for me. Don't forget that parents may get very scared about
having this done to their baby, and going to a bottle (and not having to
suffer nipple pain anymore) may seem like the best way to go. Since
incidence of tongue-tie is higher in boys (one source said 2.6:1 I think), I
mention that I have been told by many hcps that it is much simpler to do
than circumcision. (this is not a circ debate, just something for the
parents to compare to, as circs here are almost a given).
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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