Cathy WG writes:

If we  use good pain relief during and  after the procedure, there's less 
risk of  adverse neurological  consequences.

~~~
This is one very variable area, I find. Lots of  variation in pain relief,  
practice of how to visualize and assess the  area, how the baby is held and 
by  whom, instrument doing the release,  what practitioners are wearing  
professionally, post-release  assessment, chagne to breastfeed in the 
office  
before leaving,   home pain relief, and post aftercare are all variable by 
a  
lot. One  local ENT uses no pain relief before or after. I've seen babies   
actually sleep through the release she's so fast and smooth. She now  
recommends  
post-release stretching for all babies. Another one uses  swabs with pain  
reliever before each procedure, then cauterizes with  Silver Nitrate sticks 
 
after, but suggests no pain relief after and  recommends  no stretching. 
Another uses no pain relief, and recommends  no  exercises. ( The second 
two also 
do only  anterior  releases.)  It seems like it's all so new that  
professionals are  trying to find their own way. Since 2004, there has been 
so  much  
change ( 2204: When Dr. Elizabeth Coryllos, Catherine  Watson Genna and  
someone 
I admit I cannot remember, had that seminal article in  the  Summer AAP 
newsletter for the Breastfeeding Section.  ) 
It's always  a challenge being on the edge of new or newish information. We 
 
still  have quite a few busy IBCLCs who do not assess for or make 
suggestions   concerning tongue-ties that are anything but the heart-shaped 
ones at the  
tip.  So much to learn and be  learned.

Peace,
Judy


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