On posterior tongue ties, the idea that baby needs a deeper latch is not borne out by research.  Please look at the article done by Donna Geddes where she ultrasounded babies with anterior tongue ties and posterior tongue ties after frenotomy.  Those with anterior tongue ties released, took more nipple into the mouth.  Those with posterior, took less.  Both ended up with nipples at approximately same distance.  This was after overcoming muscular weaknesses associated with the initial issue.  IMHE, babies need suck therapy after release to help with strengthening the muscles of the tongue that have not been fully used.  PTT's often take 2-4 weeks to recover.  Please review Catherine Genna Watson's excellent material in her book. 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of J Nicholls
Sent: Thursday, August 22, 2013 11:36 PM
Subject: Update on baby not latching after TTR

Hello Catherine

Thank you for responding on lactnet

Apparently the  release was done because of the "long time effect of having a posterior tongue tie."

I went to see mum and baby today, and I am happy to report baby has returned to the breast, still makes the popping noise, I have explained to mum that she needs to work on achieving a deeper latch as I noticed that the nipple is wedged when baby comes off the breast.
I have also contacted the dentist to ask about the tongue grasping exercises, and I have explained that is what is written on their after care  leaflet(which needs to be corrected.) The popping noise apparently can last for several day.? I have suggested to mum that she waits for 2 weeks until the wound has healed before doing any thing. (would you all agree)

I am also waiting to hear  from 2 colleagues who were fortunate enough to go to the Tongue Tie summit about the latest research or evidence base practice.

Sincerely
June Nicholls
IBCLC

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