<<Immediate relief after frenotomy is rare>>

I think this statement is a reflection of the medical environment one is 
working in.

I realize there is NO data on this, and I am in a position to collect 
some...which I should.  But I would estimate that 80-90% of the tongue-tied 
babies I clip have immediate improvement in maternal comfort, milk-removal 
or both.

I think the variation in results stems from age at clipping (I probably tend 
to get them earlier...1-3 weeks of age), AND the completeness of clipping. 
When others in the commnity clip tongues, and I see the babies later on for 
continued difficulty, I find that at times the MD clipped the tongue back 
only to the salivary duct openings (about "half-way" to the real base of the 
tongue) leaving a fair amount of restriction.  Sometimes the frenulum is 
thicker and more vascular starting at that point, and I am also not 
comfortable going any further, sometimes it is thin and I clip it further, 
and sometimes with positioning or a nipple shield we can improve the 
situation without further clipping.

Just my experience...

Kathy Leeper, MD, IBCLC
Lincoln,  NE 

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