Running to get a release done.
When you are in pain or your baby isn’t gaining well, I know how much you want to run and get a release done. I know because this happened to me, personally. I wanted nothing more to fix the tongue tie, end triple feeding and fix the problem. And it’s exactly what I tried to do- I took my 11 day old daughter and had a scissor release with the provider my lactation consultant recommended. Unfortunately, we had a suboptimal release, did no body work and the release made no real difference. I still had to use a nipple shield for 8(!!) weeks due to pain. If I knew then what I know now, I whole heartedly believe that we could have had a better outcome. We know that body work and oral exercises before a release provides improved outcomes. All providers (IBCLCs, SLPs, MDs, and release providers) should be encouraging, at a minimum, oral exercises pre-release to get the tongue moving and ready for a release for better long term outcomes .
Not using preferred providers.
When choosing a provider to release the tie you want to find someone who is really skilled in this area. It’s very easy to not laser enough tissue (or too much tissue) and breastfeeding families are left with the same problems they had before the release. Performing a great release takes tons of practice, knowledge and training. Unfortunately, this is not a skill majority of ENTs or Dentists are taught in school but they have instead taken additional course work outside of school to gain the knowledge to do a great frenectomy. If you would like to find a preferred provider in your area, check out the following Facebook group. In the DMV, these are some great providers that I consistently see great work from:
Dr. Kaelen Black, MD, ENT (Fairfax, VA)
Dr. Rashita Jaju, DDS (Vienna, VA)
Dr. Natasha Khurana, DDS (Rockville, MD)
Dr. Su Kim, DDS (Columbia, MD)
Dr. Robert Marcus, DDS (Reisterstown, MD)
Dr. Sehela Ritter (Baltimore, MD)
Dr. Candace Zorn (Baltimore, MD)
Settling for less than a functional exam.
A picture or quick peek or sweep of the finger under the tongue is absolutely not enough information to diagnose or rule out a tongue tie. If anyone providing care for your baby does this type of exam, you likely need to get a second opinion from a skilled provider. When we do a functional exam we are looking at how the tongue and mouth are working, we can identify compensatory behavior, and are able to identify areas that need care through oral exercises. When I am doing an oral evaluation I am looking at how tight baby’s mouth is, how strong their suck is, the shape of their palate, how their tongue moves and functions, and so much more. I visualize the tongue and lip frenulums and check their tension, elasticity and structure. So, as you can see, a functional oral exam really is, and needs to be the gold standard when evaluating for tongue and lip restrictions. Again, this is not a skill that’s taught by schools or required for practicing. Those of us that possess this knowledge have gone through significant training beyond our board requirements.
Not following through with after care.
This is a tough one. There are several parts of aftercare and trudging through them can be tough. We have wound care 4-6x/day for 3-4 weeks, we have oral strengthening exercises that typically last about a month, 4x per day, and any body work that is required – typically 1x per week for about 4-6 weeks. Deciding to get a tie released is a big commitment on the parent and caregivers part. I always say the hardest part about doing oral exercises is simply remembering to actually do them. Wound care and oral exercises take about 2 minutes each, so they are pretty quick. We see much better outcomes when proper care is taken to ensure that the mouth and tongue aren’t reattaching and to work on strengthening the mouth/tongue through oral exercises.
If you think your baby may have a tongue tie and you would like an appt. please jump over to the Book Now page and grab an appt! Feed Well Co IBCLCs possess the skills and knowledge to assess oral function and help guide you through the tongue tie journey!