A common approach, at least around here, is "Wait and see".  Even when we see feeding problems right away, too many docs feel it will correct itself or the baby will learn to compensate.  Sometimes there is a very obvious "tie" but so far so good s far as initial feeding.  Then, when it becomes a very obvious problem later on and the clipping is done, it is oftgen harder for the baby to relearn how to nurse.  They may not "realize' that the tongue can now move more freely and continue to nurse in a way that is ineffective for them and painful for mom.  If the clipping had been done right at first, there would have been no problem.
The dilemma then is whether it should be clipped initially because of possible problems later.  While many would say not to fix it until we know it's "broke",  there are precedents for doing a procedure prophylactically, such as non-religious circumcisions.  (PLEASE do not take this as a starting point for debate on circs.  This is not my intent.)  
Winnie Mading IBCLC

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