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Subject:
From:
Winnie Mading <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 2 Apr 2011 09:48:58 -0700
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Laura does make a good point that some babies (in infancy and into adulthood) 
are able to get along without having a tongue-tie clipped.  This is one reason 
frequently given for a "wait and see" approach (in addition to "I don't believe 
it affects breastfeeding").  However, this approach does leave us with a 
dilemma.  When it does impact breastfeeding and is clipped after several weeks 
or even months, baby and mom have already gone through a lot of distress, baby 
may have had less than optimum development, and may have been switched to 
formula.  In addition, when clipped "later" and they do continue nursing, they 
may have to relearn as baby has gotten so used to not being able to extend the 
tongue that it takes patience and maybe even some "training" to be able to take 
advantage of the new-found freedom pf tongue movement.
If one has a broken bone - one where the bones stay well approximated, not one 
where the ends have moved - it might be argued that the bones might heal without 
casting and limiting movement so why not "wait and see".  Obviously, it is not 
wise to intervene with every variation that "might" cause a problem later.  If 
carried to an extreme, one might argue that little girls with a family history 
of breast cancer should have "prophylactic mastectomies" as young as possible 
before they get attached to the idea of having normal breasts!  We have to look 
at the potential problems that could develop if an anatomical variation such as 
tongue-tie is not dealt with early on vs dealing with them after they create 
problems weighed with the extent of intervention proposed.  From the frenotomies 
I have observed (those which do not involve more than a simple snip with only a 
tiny drop of blood if even that) babies seem to show more distress from movement 
being restricted than from the snip.  They show more distress from getting a 
shot.  (Please do not turn this into a debate about shots!)

Winnie Mading (still debating whether to renew my IBCLC since I am retired)

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