I don't think we need to apologize for using the word "diagnose"
anymore. The IBLCE removed that language from the Scope of Practice
document. The revised Scope of Practice requires "perform[ing]
comprehensive maternal, child and feeding assessments related to
lactation." ILCA Standards of Practice require us to "systematically
collect objective and subjective assessment info," and to "analyze
assessment information to identify issues or problems."
Here's the Merriam Webster on diagnose-
1.	To recognize (as a disease) by signs and symptoms
2.	To analyze the cause or nature of (a phenomenon)

Regarding the diagnosing of tongue ties: why would one look in a baby's
mouth and diagnose a tongue tie? Wouldn't one simply see it, or notice
it, or discover it? Or any of these synonymous activities:  analyze,
determine, distinguish, identify, interpret, investigate, pinpoint,
pronounce, put one's finger on, recognize (got those from an online
thesaurus)  And if it's a submucosal tongue tie and you can't visualize
it, because it's under the mucosal lining and therefore invisible,  then
maybe you palpate it, or something else. Get creative! And if you are
pretty sure, but not a 100%, then you suspect it. Or depending where you
practice and what resources are available to you and your client - you
fear it : )

Maybe you've identified what you suspect is a submucosal tongue tie but
you lack confidence: let the code of ethics give you courage! See
numbers 7, 8, 9 and 18.

So, I'm not going to apologize for using the D word, but I'm not going
to use it either. It sounds so...medical, doesn't it?  Let them keep
their word. (In fact, they can have "pronounce" too.)  I'm going to be
visualizing and palpating in clinical practice. And in my telephone
practice I'm going to be suspecting and referring! And if I'm really
lucky, ruling out.
Thanks for listening
Kristen Panzer, MS IBCLC
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