Tongue Ties again - common questions asked .

Are there more tongue ties than ten years ago ?  I suspect there are more . Posterior tongue ties are very different to anteriors , they tend to have thicker , restrictive lip ties . This combination  really makes  obtaining a good effective latch quite  difficult . Some people think its not that we now recognise them more  but they are a result of environmental contaminants and dietary issues  .

And why are health professionals  so misinformed about them ? 
 They are not seeing breastfeeding mothers everyday , they are not looking in babies mouths , they are not getting enough (or any) breastfeeding education.  There are enough studies now to prove tongue ties cause breastfeeding problems and that frenotomy is safe , low risk , effective procedure ( provided the person performing it has been trained properly) . There are a small amount of paediatricians and GPs who are supportive , hopefully it will change in the future .
There are very few studies that include posterior ties , they are harder to spot and sometimes  tend to take longer to improve feeding  once divided. 

Do all tongue ties need to be divided ? 
No , definitely not . Some ties are really stretchy and cause no feeding  problems for the baby . We don't know which ones will cause a problem with speech or misaligned teeth later in life . What is a common myth is when people say "oh he is sticking his tongue out so that tongue tie will be ok " . Extension is only one part of tongue function . 

Will a tongue tie cause a speech delay ? 
No , its more likely to cause an articulation problem  with the following sounds  l, r, t, d, n, th, sh and z.   Some children will find another way to form the sound , other will improve with speech therapy - but they are always going to be living with a tension in their oral area , which can cause a myriad of structural problems later in life. 

So how does an IBCLC assess which ties need division and which do not ? 
First of all , its not just a matter of " divide the ties and all will be ok " . Frenotomy  a link in the chain of intensive breastfeeding support and osteopathy . This is what works, I see it all the time . 
I look in every babies mouth , I assess their tongue function, looking at a tie tells me very little , looking at what the baby can do tell a lot .
I assess all babies I see with a tongue function assessment tool . This tells me which babies need frenotomy, which ones need an osteopath and which ones just need positioning  and adjustment .

Lip Ties ?  We are still learning about lip ties, it's a new discovery. I have never seen a restrictive lip tie that doesn't have a tongue tie too. Again not all lip ties need treatment . Mothers and babies  have breastfed for thousands of years ,  good support is the main key to this .

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