My tongue tie musings

I have been reluctant to talk about tongue tie in the past as I still feel so confused about what to do to help the families affected. I’ve done some great professional development in the past month or so about it, and while I feel more confident in being able to help families, there still seems to be a lack of agreement amongst the experts about what to do with a baby that may have a tongue tie.

I’m going to begin with what I am confident about:

·         Tongue ties exist.

·         Assessment of a tongue tie should look at function as well as what else is going on for the baby and family.

·         As an IBCLC, it is not within my scope of practice to diagnose a tongue tie.

·         What is within my scope is maximising the breastfeeding ability of the baby and the comfort of both parent and baby during feeding, and looking at range of movement and movement patterns throughout the rest of the baby’s body that might also be impacting feeding.

·         If everything else has been optimised, and there is still issues with the function of a baby’s feeding, the tongue tie needs to be released.

It does seem like a fairly common estimate of prevalence of tongue tie is 3-5%. I think I would see only a few babies each year that I suspect do have a tongue tie which is impacting their function, which with the smallish population of people in my area would check out with this. What I do find challenging in working with these families is:

·         For release, the families are most likely going to have to travel to a metro area to have this done. I have heard of paediatricians and dentists doing releases locally, but I am most likely going to suggest to families that they see a specialist in the field that is going to provide thorough assessment and suitable follow up.

·         This is probably going to cost quite a lot of money.

·         Organising this is probably going to take time, so there is likely going to need to be extra or alternative feeding of the baby in the meantime.

And this is all a lot for the family. It is a lot to decide to have surgery done on your baby anyway, especially with all the conflicting information available if you seek opinion from Google, without all the stress of travel.  

My recent professional development has given me some new techniques in my toolbox to assess and provide strategies to help babies with tightness that is interfering with their feeding function or help prepare them for their release in the case of a tongue tie being present. I am excited to be able to offer more to families locally and regional and remote families online. I have the option of telehealth lactation consults which can work really well in combination with the family sending through video and photos of what is going on for them and their baby to trouble shoot breastfeeding difficulties including tongue tie.

Keep growing strong, even with the challenges of tongue tie,