It's so good to see this discussion about the prevalence of tongue tie. I realize that a lot more has been learned about tongue tie in recent years, but I have to confess that I'm beginning to be really concerned about how very frequently this diagnosis is being made. It's reminiscent, in many ways, of the frequency with which Thrush was cited as the cause of sore nipples several years ago, and endless treatments suggested, but still the pain and damage didn't resolve. And then we discovered bacterial infections..... This is only a sample of one, but as an LC who worked in private practice for 13 years, and who saw slightly over 3000 mothers and babies in that time (all races, many different nationalities) and babies from the first day of birth, sometimes the first hour (I had hospital privileges) up to nursing children of 6.5 years, I did not see even one tongue tie that required frenotomy in order that a non-latching baby could latch, or a sore nipple could heal or a non-thriving baby could start to gain weight. In short, I didn't find it necessary, while facilitating and preserving effective, pain-free breastfeeding, to refer even one baby to another practitioner for tongue tie, although I did have one mother whose paediatrician recommended frenotomy at 9 months because he was concerned that the tongue-tie would impede normal speech. I went frantically back to my notes for that baby, seen on the first day of life, and saw that I'd described the tie, advised the mother and given my usual spiel about possible risks; that if the mother experienced nipple pain/damage, or if the little one didn't gain weight well then please come back and see me again. She hadn't needed to, and the baby grew fine, but the paediatrician now thought it was time to snip. What I'm saying is that while working to help babies latch, to resolve sore nipples, to work with many, many low-gain babies, and while seeing a fair percentage of babies who had mild to medium degrees of tongue tie, I didn't see even one baby whose tie was so severe that it actually caused a breastfeeding difficulty. I can't believe that of all the 20 000 or so LCs on the planet I'm the only one who has been so lucky. Breastfeeding initiation rates were 99.6%, and while about 75% of the babies I saw were experiencing a wide range of breastfeeding difficulties, about 25% of my clients were mothers who requested LC consults because they wanted to do it right from the beginning (preventive rather than therapeutic care). So there were varied races, varies ages, and a wide range of scenarios, but no very severe tongue-ties. I belong to several lists, so LACTNET is not the only place I hear about perceived tongue-tie difficulties, but some of the case histories, and the sheer volume of them, are starting to bother me. Please understand I'm not saying that I don't believe that tongue-tie doesn't exist; it does. But I do wonder if tongue-tie as a cause of breastfeeding difficulties and requiring intervention is being over-diagnosed? When I hear about tongues being snipped and the tie growing back again and having to be separated two, three or four times (!!!) while still the problem of the sore nipples or the non-latching or the low gain persists, then I can't help wondering if the cause of the problem is not something _else_. And whether the focus on the tie is not hindering further investigation? Or being snipped as a first, instead of as a last resort? If prevalence is about 4%, yet some 30-50% of babies' lingual frenula are being snipped nowadays, the maths doesn't add up. Apart from anything else, one wonders how the human race survived to the present day if ankyloglossia is both so prevalent and so problematic. More information about the stats and others' experience would be very welcome :-) Pamela Morrison IBCLC Rustington, England (formerly Harare, Zimbabwe) *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome