According to a Canadian Statement:
> Ankyloglossia is relatively uncommon in the newborn population. Most of
the
> time, it is an anatomical finding without significant consequences for
the
> newborn or infant affected by this condition. Current evidence seems to
> demonstrate that despite ankyloglosssia, most newborns are able to
breastfeed
> successfully (7,10).

1. I wonder about the word "uncommon" - I think it depends on which
population you are seeing.  I had rarely seen a tongue tie in St. Louis,
but saw almost one a week in Puerto Rico.  These WERE causing breastfeeding
problems, or they wouldn't have come to see me...

2. I also wonder about "most newborns are able to breastfeed" - again, I
see tongue tie (though much less often) here in California, and find that
most ARE able to breastfeed with minimal correction of placement - but this
was NOT the case in Puerto Rico.

I wonder if this has to do with the type of tissue the mother's breasts
are?  In listening to Peter Hartmann, he mentions the differences in
breasts between Oriental and Caucasian women,  and I have seen similar
differences among women (not necessarily connected to race) and those who
have breastfed successfully despite tongue-tie (I do not yet have a
physician who will perform this surgery unless the patient is Kaiser) have
had the very pliable (silly-putty?) type of breast.  I saw LESS of this
type of breast in Puerto Rico (again, not an adequate sampling, as I only
saw the "troubles").

So here is ANOTHER study - in addition to the evaluation of the tongue
(thank you Alison Hazelbaker) we need to add the breast tissue.

In listening to Dr. Hartmann in Ohio - I got lots of good information - but
then I commented to him that now I had more questions! He chuckled and
said, "Yes, I guess that means we all have a job for a very LONG time!"

So true!

Jeanette Panchula, BSW, RN, PHN, IBCLC
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