I wish there was more research in this area... my guess is that it is really dependant on who you have doing frenotomies for you. Where I live there are a few Pedis and FPs who clip them, but often only clip them about "half-way". By this I mean that a frenulum usually has to be pretty obvious to be clipped...coming near to the tip of the tongue. So it gets clipped a couple of mms, about to the opening of the saliary ducts in the floor of the mouth. This is enough for some babies to be "cured" of the pain or poor removal, but not enough for others. I often "reclip" these babies. I also suspect it matters how long the baby has been trying to compensate for the tongue restrictino before clipping. It seems to me the younger they are at clipping the better chance you have for an "instant fix". But if they have been chewing or whatever for 3 months before you fix it, they are less likely to instantly change their ways. (but I HAVE seen that happen as well) And then I think it matters if there is a submucosal frenulum as well (which I used to call "built-in" to the underside of the tongue) I have recently started clipping these, which can occur by themselves, or as an extension of a frenulum that visibly separates from the tongue. So sometimes you clip a visible frenulum only to find a fibrous strand continuing on into the floor of the tongue. Sometimes these kids will be better than before clipping, but not perfect. There is much to learn... Kathy Leeper, MD, IBCLC MilkWorks- Lincoln, NE The contents of this message may be privileged and confidential. Therefore, if this message has been received in error, please delete it without reading it. Your receipt of this message is not intended to waive any applicable privilege. Please do not disseminate this message without the permission of the author. *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]