At our hospital the peds do the circs.  I have
talked to 4 different peds about clipping frenulums as my youngest had a
very tight one at birth.  Three of the four felt that it was a simple enough
procedure and are willing to cut them.  One of the three even does this, I
have heard, with newborns in the hospital before discharge. The other two,
both fairly young, admitted to not much experience with doing this but since
they all share the practice they refer to the more experience doc when this
comes up for his advice when necessary.     The fourth ped, who is my
children's' first ped, felt said that the risk of bleeding was too great and
she did not think the risks out weighed the benefits. ( I found her
objections really odd since she was so up to date and aggressive with my
oldest son when he was an infant with epilepsy and a brain tumor.)  To which
I answered, " So painful nipples and years of speech therapy, as opposed to
one little clip, since you are not clipping the tongue itself where is all
the blood going to come from?"  To which she responded that it was just no
longer recommended and that the latest studies did not show any benefit. (
again I was really disappointed that, knowing me as she did, she was would
not reference herself) Well not to be blown off I simply replied, " I am
glad my neighbor is an oral surgeon, he offered to do it when he saw the
baby for the first time."   I did, however, wait to pursue getting it done.
I was not having as much difficulties with nursing, the initial pain had
passed. My child's frenulum is very tight in that he has a V in his tongue
and he could not hold his tongue past his bottom gum when he was born.  I
had difficulties with him at first because he had trouble messaging the
ducts, fortunately my anatomy is that I have a small in diameter nipple and
it is well everted so I just had to make sure that he opened wide and took
enough in.  It was different then when I nursed before, I had engorgement at
first I am sure because we were working out the kinks of how to get him to
nurse effectively, and feeds were short and more frequent.  I would say that
even though it was a rougher start we were nursing normally by week two.
Even though things worked out for us I still feel that it should be done
immediately if needed, I am not certain that most moms would stick it out
and work with it.  I had the advantage of him not being my first and of work
experience, and believe me I role played a lot those first two months, I
would say "OK Pam, what would tell a new mom to do if she called with this"


                        Today he is soon to be 3 and I have discussed with
his new peds ( switched because of insurance not because of the frenulum
issue) about clipping the frenulum because of speech.  We plan to do this in
the next couple of months.  The good news is that while he still has a V in
his tongue, he can now stick out his tongue quite well! Over his lip and
right out at ya!  He can extend out but not down or up to the roof which is
why I am concerned about the speech.  That coupled  with our two sided
family histories for males with speech impediments even for the ones who
don't have tight frenulums, we are choosing to have his clipped.

                        Also of interest is that my husband has a tight
frenulum, although  mild.  No one told his mother this 40 years ago, and he
is the only one of her 3 (her baby) that she tried to nurse.  She had blood
in her milk and they told her that meant she could not nurse because he
would only get blood and not enough milk.  She told me that nursing him was
very painful and that her breasts did not make good milk.  (She died just a
few months prior to my 12 year old's birth and I did not know anything about
breastfeeding then and  will never be able to find out what really happened)
When he was 12 and getting braces they suggested he have his frenulum
clipped because he talked with a lisp.  He, being 12, did not want to have
this done so they did not.  His lisp is only rarely noticeable now, when
tired and such, but he is the one who is most adamant about having our
infants done.  He says that he really wished that it had been done for him,
and it is not just a speech issue, it is a comfort issue as well.

                        I find it very interesting that some doctors are so
against clipping the frenulum but have no qualms about circumcisions.  I
know that is a whole other debate but really, isn't that just a cultural
practice that has made it's way into common practice in the US?


                        Pam Price
                        Community Education Coordinator
                        Women's and Children's Services
                        Trident Health System
                        Phone 843-824-5013
                        Fax 843-797-4692
                        e-mail [log in to unmask]
<mailto:[log in to unmask]>

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