In a message dated 4/2/2011 10:09:08 A.M. Eastern Daylight Time,
[log in to unmask] writes:
I guess I'm saying that there are no easy answers and I think it's grossly
oversimplifying a very complicated situation to say that all tongue ties
need to be clipped or that conversely, as some MD's seem to believe, no
tongue ties need to be clipped.
Laura,
You are so right. Still, I don't actually know anyone, IBCLC or MD who
thinks all tongue ties need to be released. Local ENTs are not out looking for
tongue tied babies, though some of the pediatricians seem to think they
are. These ENTs and Pediatric Dentists get referrals from us IBCLCs, not
because we see that skin under the tongue, or feel it, but because a functional
issue has been demonstrated. I agree that in time, some babies will learn
to work around their limitation and may not have future speech articulation
issues. I've seen a baby who suddenly got strong enough, and big enough by
3 weeks to get a full feeding at breast, without causing pain. Baby was
partially breastfeeding prior, with
medium/ minor pain. I've also seen babies whose moms have been patiently
waiting for 6-12 weeks and baby still cannot feed without causing extreme
pain, and get satiated normally. It would be great to have real research.
My sister and her husband are both tongue tied, we realized, when I
identified my nephew's restriction almost 5 years ago. Neither parent has speech
issues, but my sister reported afterwards "that's why he such a bad kisser."
They both do have more dental problems than me or my brother, who are not
tongue tied. Both of their children had severe and ongoing nursing problems,
and also bottlefeeding challenges before the releases were done. (Nephew
could latch but caused wounding and pain at every feed and could never
finish satiated even at a month. My sister steeled herself for 3 painful
nursings a day and he got only her milk after a good pump built her supply to
normal. His bottlefeeding improved after the release but not much change in the
nursing. I believe he needed bodywork but could not convince my sister.
Also there were no post-release exercises being done at that time. I think
this might have made a difference as well. Niece born 4 years later, tongue
tie, no latch at all, unless in super supportive position, and then no milk
transfer at all, even at 3+ weeks of age. After release, with a local
IBCLCs help( thanks to both Barbara L and Barbara LZ) , niece fully off bottle
and only breastfeeding within weeks, after absolutely no change before.)
Would she have gotten there by 6-12 weeks? I doubt it. I know my sister was
exhausted and stressed and this felt like a really good decision to her.
Honestly, it was the best Christmas gift I ever received to see her just calmly
sitting on the couch, nursing her baby. There's a lot we don't know, and
I admit I have neither a magic wand nor a crystal ball in my bag. I think
most IBCLCs just work really, really hard to assess everything, try lots of
things, strategize, reassess and discuss my assessments and what might
helpful to move a family forward toward an "enjoyable", as Dr. Kotlow says
breastfeeding relationship.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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