Connie,
Yes, that "D" word rears its ugly head again!  Technically, a non-MD
LC cannot "diagnose" things like tongue tie and thrush even though
we are probably in a better position and with more knowledge of
topics like these than many docs are.

I find myself using the phrase "What I'm seeing (or hearing) is
consistent with............  Only the doctor can diagnose it for
certain however."  I will point it out to the parents. "Do you see
that web of tissue under baby's tongue?  Notice how it seems to keep
the baby from baing able to stick its tongue out?"  I'll describe
the role the tongue plays in nursing effectively and state that
sometimes when the tongue looks like her baby's, it is difficult for
baby to get AND KEEP the tongue placed well for effective nursing.
I go on to state that sometimes it helps to have that web of tissue
snipped.  Unfortunately, not all docs are familiar with the
procedure and some don't believe it makes a difference.  I may also
go into a brief history of "snipping the tissue".  When it went out
of favor to routinely snip them, it coincided with the decline in
breastfeeding, so the connection was missed for some time.  I tell
them to check it with their doc and if that doc is not receptive, I
can give them the name of one who is.
I find that parents tend to have a lot of concern when the subject
is brought up.  I point out that while correcting such a "variation
from average" in an adult frequently requires major plastic surgery,
in a newborn it is a relatively simple procedure-certainly far less
invasive than a circ.  (Not taking sides on the circ-no circ
debate-simply comparing the procedures.)

While it is frustrating to have to play word games, unfortunately,
it is sometimes necessary to do so.  If we stick to describing our
observations without using medical words we should be OK.  We soon
learn with whom we can call a duck a duck and with whom we have to
describe it as a bird with webbed feet that goes "quack" and swims!

Winnie

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