Just got home from a delightful afternoon at a tongue tie
presentation. A staff family practice dr. discussed tongue-tie. She had
given the same talk last October at a Peds Grand Rounds. This one was
even better for several reasons, some due to a warmer, closer knit group,
and a case from the week end to discuss on a 21 day old baby with slow
weight gain who had a frenotomy Monday and Mom reported much improved
comfort with breastfeeding immediately. The case was complicated by a
horrendous social situation the mother is in, and otitis media in the
infant. She had been letting the baby sleep 7 hours at night and
breastfeeding q4h during the day....that's only 5 or 6 feedings per 24
hours. Her milk supply seemed bountiful, easily expressed, baby
swallowed with about every 3rd suck, so I didn't want to add pumping
quite yet, just wake baby during light stages of sleep and feed when baby
displays early feeding cues, q 1-2-3 hrs or so. I think the "restricted
tongue movement" (one of the fp docs first used this phrase....I love
it...stroke of genius...more easily defined and less emotional) was a
factor in the slow weight gain, impairing adequate milking of the
lactiferous sinuses, but other factors contributed, one being the mom
letting baby sleep so much.
She also had some nipple soreness, so maybe was avoiding frequent
feedings for this reason.
Tongue tie is still quite a controversial issue at my hospital, but
getting better!
I got to be the LC representative and answer a few questions. The
presenting doc also explained the study we will be starting this summer,
mainly identifying babies with restricted tongue movement. We won't
withhold frenotomy if indicated, and those babies will be followed, but
the study mainly is for numbers and to answer the hypothesis: does
restricted tongue movement of an infant affect breastfeeding? Maybe the
answer will make into some pediatric textbooks someday! :-) We will use
the Hazelbaker assessment tool, Allison if you are reading this I will be
contacting you soon. Maybe treatment outcomes will be the next study!
Good day to all,
Susan Potts Minnesota rn ibclc
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