Katherin writes:

How  often are you all seeing non-problematic ankyloglossia?

I've always  assumed it's always a problem to some degree but I realize 
that could be  because I *only* have contact with moms who are having problems 
- generally  major problems.   Many of you see moms routinely in the 
hospital  before problems have occured.


~~~ Once in a while I see one, and then we assess together whether it's an  
issue or not. If the residual connection is  stretchy enough ( like  the 
red rubber bands on US blueberry containers, which it seems people see all  
the time) and  the tongue  has good range of motion, power and  coordination, 
and the baby gets adequate milk without pain for mom or protracted  feeds, 
we just talk about making sure that remains the case, with monitoring  over 
time, and especially as babbling should begin, and solids and more speech  
milestones. This is the case probably only about 10% of the time, which makes  
sense because most moms who are calling me know their baby cannot/does not 
feed  well for some reason. I'm just the one who explains why this may be 
so.  The flip side is that most posterior ties are still not being identified  
by local MDs and even some local IBCLCs, as well as moms being told that 
that  "little" tongue-tie is not the reason for their pain, frustration, 
choking baby,  poorly feeding baby, non latching or sleepy baby, low milk supply, 
etc. I tell  them my definition of a tongue-tie that is not an issue is 
that mom should be  comfortable and baby should be able to feed well in a 
reasonable amount of time  to satiation. Not to be too crass, but really "size  
[or appearance] doesn't matter", it's function. :)
 
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA

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