Jennifer:
Thanks for the comprehensive post.
More questions: If lip ties are to be preventatively revised, is it only on
level 4 ties?
And please inform about the relationship between lip ties and caries.
I'd not heard of the connection between ties and adult problems.
As far as folic acid; how do you address the fact that so much of our
grains/grain products have been fortified with folic acid?
Looking forward to your input.
Melinda Harris-Moulton ARNP IBCLC
Olympia, WA
On Tue, Jan 7, 2014 at 10:14 PM, Jennifer Tow, IBCLC <[log in to unmask]>wrote:
> In 2010, at the IATP Summit in Toronto, we face the dilemma of language
> variability between dentists, doctors and IBCLCs in describing the anatomy
> around ties. Larry and I pretty much formed the committee at that
> conference to see what we could do to address the varying issues related to
> education, language and uniformity on the issue of lip tie (which at the
> time were referred to as labial or maxillary frena or frenula depending on
> who you asked).
>
> As to lip ties causing caries, Larry has published to that effect in JHL.
> It is one of the reasons we all took a closer look at lip ties, bc clearly
> there is more involved than the mechanics of latch.
>
> Larry and I began working together frequently and discussing the issue
> globally, especially as I was in Paris and in discussion with a lot more
> folks in EU. Basically, Larry simply realized that referring to the
> restriction as a lip tie solved the language problem completely and really
> simplified things for parents who had often had no idea what "maxillary" or
> "labial" meant. At that time the Tongue-tie Baby Support group on FB was
> co-Admined (along with mothers and a few other HCPs) by myself and several
> other IBCLCs, most of whom have become active in IATP . We decided to
> change the language and it was very simple to do as we had a huge audience.
> One of the positives of social media in that case.
>
> Another thing we did was actively seek out dentists to revise babies,
> although we made every effort to educate them about babies, breastfeeding
> and ties. Most were flying to Albany to observe Larry and learn about
> integration of care, including from EU, so outcomes were generally quite
> good.
>
> The flip side is that lip ties are very easy to spot and mothers started
> figuring them out for themselves and calling local dentists, who of course
> are very familiar with lip ties, which are often revised when kids have a
> diastema or have braces. This meant that dentists who had no idea how to
> recognize or even revise a TT were beginning to do lip ties, and that meant
> a whole new education effort. I feel like a broken record when I tell
> mothers "It is very, very rare to see a LT w/o a TT". And it becomes a red
> flag as to a provider's assessment skill when the mother says her baby only
> has a LT as well.
>
> Do LT's need revision? IMO, a restriction needs revision, while a frenum
> may or may not. I have personally trained this past year as an oral facial
> myologist so that I could better understand the function associated with
> ties and develop interventions to help babies normalize function. I have
> been collaborating with folks involved in sleep medicine as the long-term
> consequence of oral restrictions are impaired airway function and sleep
> issues leading often to gut issues and behavior issues (the gut-brain
> axis). I will be giving a guest lecture at a dental school this Spring on
> breastfeeding for a post-grad program on airway function. The dentists I am
> collaborating with are very much interested in prevention.
>
> I was in the UK in October to lecture on Epigenetics and Breastfeeding and
> met with two dentists in London who are exploring dealing with various
> sequela from untreated ties and oral dysfunction. From posture to airway
> function/sleep to digestion and behavior, oral restrictions are a very big
> deal.
>
> On the other end, I began referring all my TTd babies for testing about 2
> years ago for MTHFR and when over 90% were coming back positive, I
> contacted one of the world's leading researchers in MTHFR and asked him
> why. My clients were eager to know as well, so they each paid a $35 fee to
> attend a webinar he produced after spending scores of hours delving into
> the research to find some answers. He also presented that material at IATP
> last year. Since then, he has found more evidence suggesting the use of
> synthetic folic acid as a key factor in midline defects and tongue-tie.
> Folic acid does not ever occur in Nature and seriously impairs methylation
> in all humans, but especially in the 40%+ of the population with a SNP
> (mutation) at the MTHFR gene. Various forms of methylated folate are now
> being added to high quality supplements as a safe form of folate. The
> entire biochemistry is far more complex and is an issue of maternal
> nutrition and toxin exposure, not simply of taking a supplement.
>
> So, I do not think that ties should be revised only if they obviously
> interfere with breastfeeding. If breastfeeding is managed in a compensatory
> way, then oral function is compromised. If oral function is compromised,
> then human health is compromised. Nose breathing is the single most
> important function of the face. If we do not preserve nose breathing, we
> suffer long-term consequences as I mentioned above.
>
> IATP is working to define policies and protocols for assessment and
> treatment, recognizing these other implications. We are working to develop
> clinical competencies for IBCLCs, revisers and bodyworkers. We are
> concerned that mothers are getting incomplete information from other
> mothers, but in all fairness many..perhaps most..are getting more accurate
> assessment from strangers on FB than their providers, including IBCLCs who
> have been slow to learn about TT/LT. as my interest is broader, I am in
> frequent conversation with the folks involved in OMT and sleep/airway and
> am working to change our access to knowledge on these subjects.
>
>
>
>
>
>
>
> Date: Tue, 7 Jan 2014 20:23:54 -0800
> From: Melinda <[log in to unmask]>
> Subject: Re: Lip Ties
>
> Good point, Jane, about the relationship between lip ties and dental
> caries.
> I wonder about if/when a pediatric dentist or other provider would revise
> a tie
> that is not inhibiting feeding --do they wait until caries occur, or do
> they
> clip ties preventatively?
> My experience is in observing Dr O'Hara in Seattle, who mentioned that
> many lip
> ties (that are not causing problems with breast-feeding) will "revise"
> themselves in the course of typical childhood injuries. She did not (that
> I know
> of) perform any 'preventative' lip tie revisions.
> Melinda Harris Moulton FNP, IBCLC
> Olympia, WA
>
> Sent from my iPad
>
> > On Jan 6, 2014, at 8:03 AM, [log in to unmask] wrote:
> >
> > When it comes to lip and tongue ties, we need to have input from
> dentists who
> are into preventative care. I have seen babies who successfully nursed
> despite
> lip and tongue-ties turn into babies with "bottle-mouth caries"! I am
> wondering
> in cases where dentists are blaming nighttime breastfeeding for caries, if
> what
> is really the problem is lip ties. This causes excessive pressure on soft
> tooth
> enamel of erupting teeth, especially the top ones - and voila! - cavities
> in the
> top teeth!
> >
> > -----Original Message-----
> > From: Lactation Information and Discussion [mailto:
> [log in to unmask]]
> On Behalf Of Melinda
> > Sent: Saturday, January 04, 2014 9:51 PM
> > Subject: Re: Lip Ties
> >
> > I am eager to get others opinions. I am on the tongue tie support site on
> Facebook, and have noted lots of talk about both tongue and lip ties--but I
> guess that's what one would expect on a site devoted to this issue.
> > I believe the interest in 'ties' over the past decade is that many women
> with
> very sore nipples, who would've just switched to bottle feeding in previous
> years, are now seeking out the causes for such pain and ways to correct it.
> > I am an advocate of revising lip and tongue ties, but only when they
> prevent a
> successful breastfeeding relationship. IBCLC's need to be able to perform
> an
> oral exam/ assessment in addition to a feeding evaluation to determine the
> effect a tie is having.
> > Melinda Harris -Moulton FNP IBCLC
> >
> >
> >
> >
> >
> >
> > Sent from my iPad
> >
> >> On Jan 4, 2014, at 6:57 PM, Kathleen Huggins <[log in to unmask]>
> wrote:
> >>
> >> Hello to everyone from warm, sunny Central California! Being from
> Buffalo, I
> feel your pain if you are suffering with the extreme cold! I have recently
> started responding to nursing mothers on a popular breastfeeding website.
> I
> have been quite surprised at the number of mothers responding to mothers
> experiencing breastfeeding issues and their advice. Everyday, nursing
> mothers
> post to those having problems to check for "lip ties" and to ask
> physicians to
> get them clipped so that their particular problem will be solved. I see
> this
> with any moms experiencing latch issues, painful nursing, fussing at the
> breast, making sounds while nursing, etc, etc. It reminds me of the
> 1980's when
> we all thought anyone with sore nipples must have yeast!
> >>
> >> So, what am I missing here? Where is this coming from? I have missed
> ONE
> ILCA conference in 25+ years. Was that the conference that was all about
> lip
> ties?
> >>
> >> Anxiously awaiting to hear where this is coming from!
> >>
> >> Thanks to all!
> >>
> >> Kathleen
>
>
>
> Jennifer Tow, IBCLC, USA & France
> Intuitive Parenting Network, LLC
>
>
>
>
>
>
>
> ***********************************************
>
> Archives: http://community.lsoft.com/archives/LACTNET.html
> To reach list owners: [log in to unmask]
> Mail all list management commands to: [log in to unmask]
> COMMANDS:
> 1. To temporarily stop your subscription write in the body of an email:
> set lactnet nomail
> 2. To start it again: set lactnet mail
> 3. To unsubscribe: unsubscribe lactnet
> 4. To get a comprehensive list of rules and directions: get lactnet welcome
>
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
