*Leeper...my apologies for my spell checker!
Holly
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From: Holly McSpadden
Sent: Wednesday, June 19, 2019 9:09:41 AM
To: Lactation Information and Discussion
Subject: Re: stretching exercises
Thank you, Dr. Keeper!!
Holly McSpadden, IBCLC
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From: Lactation Information and Discussion <[log in to unmask]> on behalf of Kathy Leeper <[log in to unmask]>
Sent: Wednesday, June 19, 2019 8:24:58 AM
To: [log in to unmask]
Subject: Re: stretching exercises
There is absolutely no objective evidence that stretching underneath a tongue after frenotomy is necessary or even helpful. I have done hundreds of frenotomies with scissors, and never asked anyone to stretch after.
We do not know…maybe laser frenotomy causes more inflammation (as it is a burn, not a slice) and causes more scarring. There is no research on that either. But stretching months later will certainly not be helpful.
Please stop recommending torture of babies by manipulating burns in their mouth. It has to be very painful, and has caused oral aversion/refusal to eat/failure to thrive in my community. There is not other situation where stretching a wound after a surgical procedure is recommended. IF the baby is using their tongue correctly, they will naturally stretch it by suckling. It is my opinion that the babies who “reattach” or “scar down” do so because their tongue is not functioning normally, even post-release.
I have been doing bf medicine for 18 years. Frenotomy can be helpful in babies who truly need it! But the frenetic overuse of laser frenotomy for tongue and lip tie (and buccal tie????) has caused a huge backlash against frenotomy in the medical community that saddens me. Posterior frenulae are very common, but not always the cause of breastfeeding difficulty.
Stepping off of soapbox…
Kathy Leeper, MD, IBCLC, FABM
Breastfeeding Medicine Specialist
Medical Director
MilkWorks, a non-profit Community Breastfeeding Center
5930 South 58th, Suite W
Lincoln, NE 68516
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