It's very easy to correct a posterior tongue tie, all it takes is a
little snip or two, just like the more up-front ones. Can be done with
just a little topical anesthetic, in an office setting.
Some babies with tongue ties improve as their mouth grows and they can
take a larger mouthful of breast, some babies improve if their mother
increases her milk production with a breast pump and they don't have to
work as hard, and some keep hurting mom and keep sucking inefficiently.
It is hard to predict.
The babies who can attach, maintain their attachment for at least a few
minutes at a time, and can keep their tongue tip over the lower gum
ridge CONSISTENTLY during sucking are more likely to go on to breastfeed
adequately. Tt babies are almost never as efficient as babies with free
tongues, they take longer to feed and often feed more often, but if mom
is patient some of them can do it. If we can get a tolerable latch, and
baby is moving sufficient milk, I just monitor the dyad. If the baby
can't latch at all, or can't maintain the tongue over the gum ridge
during sucking at the breast (a finger is skinnier, remember that!), or
is very inefficient at transferring milk, the prospects are poorer, and
I encourage mom to see a specialist sooner.
Hope this answers your questions.
Catherine Watson Genna, IBCLC NYC
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