Arly, I am lucky enough to work in a place where it is easy to get a
tongue-tie clipped.  Virtually all the Pediatricians and Family Practice
docs will clip a frenulum on our recommendation.  When many of them see an
obviously tight frenulum on a newborn exam it's been clipped before we even
see the baby.  I have come to believe that even those marginal tongue-ties
can cause problems.  It depends on the length of a baby's tongue overall
and mom's anatomy (length of nipples, elasticity of nipple and areolar
skin).  If we're in doubt, we give it a few days and work on getting the
best positioning possible with the chin tucked firmly into the breast and
the head extended.  If this doesn't do it, we recommend frenotomy.  Most of
time it helps significantly.  We're now recommending frenotomy and seeing
positive results on babies that years ago I would have been "sure" the
frenulum wasn't tight enough to cause a problem.  So--go for it!

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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