On Tue, 26 Dec 2006 Chayn wrote, in her followup about a mother

< "The mother and I both felt that the baby's tongue was not the issue.   I 
suspected a submucosal tongue tie but the baby has no trouble sticking his 
tongue out past his bottom lip. (please correct me if that doesn't mean that 
the tongue isn't tied) ">

Actually, Chayn, occasionally one sees a tongue that is restricted but it is 
easy to miss, because the baby can poke her tongue.  I well remember a baby 
I saw a few years ago, with growth faltering that was of concern.   I 
suspected a tongue tie but the little girl could point her tongue forward 
quite nicely.  As something didn't add up, I looked again and found that she 
couldn't *lift* her tongue adequately.  So she wasn't effective at draining 
the breast, hence the growth faltering after the frist few weeks.  The 
frenulum was not the classical string-like one.  It was clipped by one of 
the doctors on the list I gave the mother and there was an improvement, but 
they needed a lot of follow-up from me to maximise function.

So, yes, there can be restricted tongue movement that isn't as easy to 
evaluate.  I'm glad I checked further.  The Hazelbaker tool for lingual 
frenulum assessment is useful, if in doubt.

Cheers
Virginia
in rainy Brisbane.

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