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Tongue Tie, Lip Tie and Structure

These presentations focus on the assessment, diagnosis and treatment of tongue-tie and other structural issues that have a negative impact on normal infant sucking skills and development.

Hours / Credits: 1 (details)
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New Zealand Dr. Yvonne LeFort, MD, FCFP, FRNZCGP, FABM, IBCLC

Dr. Yvonne LeFort has been a family physician for over 25 years and is based in Auckland New Zealand. She is a graduate of Dalhousie Medical School and University of Calgary Family Medicine in Canada. She is a Fellow of the Academy of Breastfeeding Medicine since 2013.

She has been involved in helping breastfeeding mothers and babies for 18 years. Her specific interest in tongue tie and its management was nurtured through her association with Dr. Evelyn Jain who was a true pioneer in the recognition of the importance of breastfeeding and the impact that untreated ankyloglossia can cause on the breastfeeding experience.

Dr. LeFort has established a private Breastfeeding Clinic in Auckland New Zealand providing comprehensive lactation care for mothers and their infants. Her service includes the management of tongue tie and involves a lactation consultant for parallel breastfeeding support.


New Zealand Dr. Yvonne LeFort, MD, FCFP, FRNZCGP, FABM, IBCLC
Abstract:

Great interest has resulted from discussions and blogs concerning tongue-tie which have not always appeared to be mindful the research and evidence of the past 20 years. Much of the basic clinical management of the tongue tied breastfeeding infant and mother has evaporated from these discussions quite inappropriately. I would like to bring us back to the basics of this issue and remind us of what evidence does and does not exist.

The management of any breastfeeding issue remains the realm of the lactation consultant and tongue tie is no exception. Unlike a true stand alone surgical condition, the management of tongue tie requires pre-operative assessment and post-operative strategies to primarily protect the breastfeeding relationship thereby optimizing outcomes. The key guiding factor must be “primum non nocere” – first do no harm – to the breastfeeding relationship. Case studies will be shared that demonstrate the approach taken by the clinician and lactation consultant. Appropriate management and outcomes will be discussed.


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Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 4 Weeks
Hours / Credits: 1 (details)
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United States Lori L. Overland, M.S., CCC, C/NDT, CLC

Lori L. Overland, M.S., CCC-SLP, C/NDT, CLC is a licensed speech and language pathologist with her neurodevelopmental certification and certificate as a lactation counselor. Lori is currently working on her IBCLC under the mentorship of Dr. Tina Smilie M.D., IBCLC, and Cathy Watson-Genna IBCLC. Lori’s private practice focuses on infants, toddlers and preschool children with oral sensory-motor/feeding disorders. Lori has co-authored two books: A sensory motor approach to feeding, and Functional assessment and treatment of tethered oral tissue. In addition to her private practice, Alphabet Soup, Lori is a member of the TalkTools® speakers’ bureau, and has lectured on sensory-motor/feeding disorders around the United States and internationally. Lori holds degrees from Hofstra University and Adelphi University.

United States Lori L. Overland, M.S., CCC, C/NDT, CLC
Abstract:

This session will focus on functional assessment and treatment of tethered oral tissue in the breastfeeding infant. Participants will understand the importance of task analysis of the motor skills to support sucking, prior to referring an infant for a release. Post op treatment has focused on active wound management (Ghaheri, B. 2017) rather than neuromuscular re-education. This approach multidisciplinary approach encourages lactation consultants to partner with body works specialists and speech pathologists to develop the underlying motor skills to support sucking.

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Presentations: 10  |  Hours / CE Credits: 10  |  Viewing Time: 8 Weeks
Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 8 Weeks
Hours / Credits: 1 (details)
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USA Dr. Scott Siegel, MD, DDS, FACS, FICS, FAAP

Dr. Siegel is a pioneering Tongue Tie surgeon, mentored through medical school, residency and in private by practice by the late Elizabeth Coryllos, MD. He is a dual degree MD, DDS Oral and Maxillofacial Surgeon, lectures internationally and publishes on the topic of Reflux associated with Lip and Tongue Ties.

USA Dr. Scott Siegel, MD, DDS, FACS, FICS, FAAP
Abstract:

This study aims to show a correlation between aerophagia in infants with tethered oral tissues (TOT’s) consisting of ankyloglossia and shortened maxillary labial frenula (tongue and lip-tie) and reflux. Currently there is little to no data on aerophagia as a possible cause of reflux in infants. Infants with tongue and possibly lip tie often have a poor latch in which there is often an inadequate seal around the breast and inefficient transfer of milk. As a result many of these infants swallow air during breastfeeding. Many of these infants suffer from symptoms of reflux. This study and results to demonstrate a correlation of ankyloglossia and shortened maxillary labial frenula with aerophagia and reflux.Treatment of these infants with a relatively simple frentomy procedure may reduce or eliminate reflux in this population.

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Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 4 Weeks
Hours / Credits: 1 (details)
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United States Brandi Benson, DC, CACCP

Dr. Brandi is the pediatric chiropractor in a practice that provides chiropractic care for women and children. Her focus is on infants with feeding difficulties and children with neurodevelopmental delays. Dr. Brandi created a program at her practice which incorporates chiropractic, optimal nutrition, myofascial/cranial-sacral techniques, and neurofunctional exercises into one comprehensive program. Her ultimate goal is to naturally support the body (brain, gut, spine and immune system) to work together in balance and help children achieve their maximum life potential. Dr. Brandi attended Cleveland Chiropractic College after earning a bachelor’s degree from the University of Missouri- Kansas City. She is also certified by the Academy of Chiropractic Family Practice. In her free time, Dr. Brandi enjoys spending time outdoors with her husband and two sets of fraternal twins.

United States Brandi Benson, DC, CACCP
Abstract:

Oral ties are often diagnosed and released during infancy to improve the breastfeeding relationship between mother and baby. But what happens if ties go undiagnosed? This course will review tethered oral tissues and their relationship in a breastfeeding dyad and the neurodevelopment of an infant and beyond. We will explore the implications of oral restrictions on the myofascial system throughout the body. Movement patterns, posture, and primitive reflex integration can all be affected by oral ties. Signs, symptoms, assessment tools, and strategies for co-management between IBCLC and bodyworkers will be discussed. Attendees will also learn neuro-biomechanical implications of TOTs beyond breastfeeding. Several case studies will be discussed and how successful management can be achieved with a team approach.

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Presentations: 10  |  Hours / CE Credits: 10  |  Viewing Time: 8 Weeks
Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 8 Weeks
Hours / Credits: 1 (details)
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U.S.A. Dr. James Murphy, MD, FAAP, FABM, IBCLC

James G. Murphy, MD, is a private practice pediatrician specializing in Breastfeeding Medicine. He was formerly an Assistant Professor of Pediatrics at the F. Edward Hérbert School of Medicine, Uniformed Services University of the Health Sciences. He served 25 years active duty as a physician with the US Navy, 12 years as a contract pediatrician with the US Navy and 6 years as a Government Service Medical Officer at the Naval Medical Center in San Diego, CA. He is a Fellow of the American Academy of Pediatrics, a Fellow of the Academy of Breastfeeding Medicine, Vice President of the San Diego County Breastfeeding Coalition, a member of ILCA and, since 2009, an IBCLC. Dr Murphy began performing lingual frenulotomies in Oct 2003 and has performed over 2800 of these procedures to date including posterior sub-mucosal fibrous bands and 300 Upper Lip Tie releases.

U.S.A. Dr. James Murphy, MD, FAAP, FABM, IBCLC
Abstract:

The concept of Tongue Tie has changed as expertise in the recognition and management of this entity has expanded. Also the consequences of not recognizing and effectively managing this entity and the “Faux Ties” which mimic it are many and expanding as data is collected to document the relationship. Breastfeeding is the most obvious and most severely affected function in infancy. Additional problems become apparent as the infant grows and develops into an ever more complicated organism. This presentation will discuss the many variations of tongue anatomy which present as a Tongue Tie, how to recognize each of these and the consequences of not managing this problem effectively in early infancy.

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Presentations: 6  |  Hours / CE Credits: 6.0  |  Viewing Time: 4 Weeks
Available in: Tongue-tie Lecture Pack
Hours / Credits: 1 (details)
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David Elad is a Professor of Biomedical Engineering at Tel Aviv University since 1985.  He received his B.Sc. in Mechanical Engineering on 1973, M.Sc. and D.Sc. in Biomedical Engineering on 1978 and 1982, all from the Technion, Haifa, Israel. He was then awarded the Rothschild and Bantrell post-doctoral fellowships at Imperial College London and M.I.T.    
David pioneered computational studies of biofluid transport phenomena in the nasal cavity in the late 80's. In the early 90's he established a comprehensive research program in bioengineering of human reproduction, both at Tel Aviv University. He developed his expertise in the fields of Respiratory Biomechanics and Reproductive Bioengineering, from complete organs all the way to the cellular levels. The respiratory studies included integrative assessment of respiratory muscles, transport phenomena in the human nose, objective noninvasive evaluation of nasal function and mechano-transduction of nasal epithelial cells cultured under air-liquid interface conditions, including effects of air-pollution. The reproductive studies included the role of uterine peristalsis in early human life, pre-implantation embryo transport after IVF, feto-maternal blood circulations in the placenta, transport of nutrition, pharmaceuticals and carcinogenic materials across a tissue engineered placental barrier, mechano-transduction of cultured ovarian cancer cells and biomechanics of infant breastfeeding. He published over 120 articles in peer-review journals and was the leading editor of 5 special journal issues in reproductive bioengineering, respiratory biomechanics and biofluid mechanics.
David has been a visiting scholar at Imperial College London, Massachusetts Institute of Technology, Northwestern University, Nagoya Institute of Technology, Drexel University, Georgia Institute of Technology, University of Toronto, City College New York and Columbia University. He is a member of the World Council for Biomechanics (2002-14) and a fellow of the American Institute for Medical and Biological Engineering (2004), the Biomedical Engineering Society, USA (2005) and the International Academy of Medical and Biological Engineering (2013).
Dr. Elad is currently on sabbatical leave from Tel Aviv University and affiliated with the Department of Biomedical Engineering of Columbia University.

Abstract:

The physical mechanisms executed by the infant during breastfeeding have been intriguing topics that lead to a long scientific controversy; whether it is sucking of the milk or mouthing of the nipple/areola. We developed a dynamic analysis of ultrasound video clips acquired during breastfeeding in order to explore the kinematics of the tongue. Then, we have developed a three-dimensional biophysical model of the breast and lactiferous tubes that enabled mimicking latch-on and the dynamic characteristics of the tongue and nipple observed in ultrasound imaging during breastfeeding. Then, we simulated breastfeeding and explored the biomechanical aspects of breastfeeding. We demonstrated that latch-on to draw the nipple/areola into the infant mouth, as well as milk extraction during breastfeeding, require development of time varying sub-atmospheric pressures within the infant's oral cavity. Analysis of infant tongue motility was compared between breast and bottle feeding. The presentation will also include discussion of oral pressure measurements.

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Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 4 Weeks
Available in: Infant Suck Lecture Pack
Hours / Credits: 1 (details)
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U.S.A Karese Laguerre, RDH, Myofunctional Therapist

Karese, like many parents, suffered in silence while her children struggled with the symptoms of undiagnosed sleep and breathing issues. One visit to a pediatric dentist changed the trajectory of their lives. Already a Registered Dental Hygienist (RDH), Karese, trained with Sandra Holtzman, Lois Laynee and Sarah Hornsby to establish her orofacial myology knowledge. With this initial training and numerous others, in a few short years she has not only resolved all her children's issues, but helped hundreds of patients, children and adults alike, discover how great life can be functioning on full. Her private practice, The Myo Spot is now a leader in the quest for myofunctional therapy awareness and public education. Her latest published book, Accomplished, delves into how to sleep better, eliminate burnout, and execute goals. Karese's mission is to transform and positively impact as many households as possible through dynamic breath, brain and body work.

U.S.A Karese Laguerre, RDH, Myofunctional Therapist
Abstract:

Anticipatory care plays an essential role in achieving desirable outcomes after the revision of tethered oral tissues. Tethered oral tissues are a common and underdiagnosed problem that impacts potentially 10% of the United States population. Lack of a universally accepted approach to diagnosis, treatment, and management creates confusion for the public and prohibits optimal care. This lecture dissects current research, trends, and information to present a deeper connection between oral function and anatomy during breastfeeding and tethered oral tissue revision management. Discover the interdisciplinary approach to restoring a functional and healthy breastfeeding relationship to the dyad and the critical importance of setting families up for success by providing adequate anticipatory care and guidance prior to revision.

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Presentations: 10  |  Hours / CE Credits: 10  |  Viewing Time: 8 Weeks
Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 8 Weeks
Hours / Credits: 1 (details)
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Bobby Ghaheri, MD is a board certified ear, nose and throat specialist with The Oregon Clinic in Portland, OR. His interest in treating children with tongue and lip-tie stems from his ardent support of breastfeeding and was furthered by his personal experiences, as his youngest child benefited from treatment for it. He enjoys working with children and has an interest in traditional and non-traditional approaches to pediatric pain control. To communicate with him, feel free to email him at [email protected] or follow him on Twitter at @DrGhaheri.

Abstract:Numerous symptoms may arise which prevent mother-infant dyads from maintaining desired breastfeeding intervals. Investigations into treatments which positively influence breastfeeding outcomes allow for improved patient counseling for treatment decisions to optimize breastfeeding quality.

Surgical release of tongue/lip-tie results in significant improvement in breastfeeding outcomes. Improvements occur early (1-week postoperatively) and continue to improve through 1-month postoperatively. Improvements were demonstrated in both infants with classic anterior tongue-tie and less obvious posterior tongue-tie. This study identifies a previously under-recognized patient population that may benefit from surgical intervention if abnormal breastfeeding symptoms exist.
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Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 4 Weeks
Hours / Credits: 1 (details)
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Okky Nafiriana, MD is a member of Praborini Lactation Team, Indonesia.

She believes breastfeeding is the best way to feed and nurture baby. But breastfeeding not always comes easy. Experienced breastfeeding her 2 daughters who were born with tongue and lip tie, made her realize the problems came with the ties and support frenotomy.

She currently works as a lactation counselor in Permata Depok Hospital and Puri Cinere Hospital, Indonesia, where she meets parents and educates the benefit of breastfeeding. She loves to study and currently pursued her dreams to deepen her knowledge in lactation.

Ratih Ayu Wulandari, MD, IBCLC is a member of Praborini Lactation Team, Indonesia.

She believes breastfeeding is the best way to feed and nurture baby, therefore she became a breastfeeding counselor in 2012 and then IBCLC in 2014.

Experienced breastfeeding her three tongue-tied babies, she understand the pain and support early frenotomy.

She is practicing frenotomy for tongue-tie and lip-tie in Puri Cinere Hospital Depok Indonesia and a private practice. Her publications are including articles for international journal and books for mothers. Japan society of ADEL acknowledges her as Specialist of ADEL (Ankyloglossia with Deviation of Epiglottis and Larynx).

Abstract:

Successful breastfeeding depends on an infant’s latching onto the mother’s breast correctly. A poor latch will cause insufficient milk transfer that will cause poor growth. Each type of mammals produces different components of milk which make it species specific, which adjust to their needs, growth rate and breastfeeding habits. Human breast milk has many benefits for human babies because it contains various substances both as nutrition and as protection.

The authors present two infants who suffered ankyloglossia, which hindered the baby’s ability to breastfeed and eat solid food. These babies were diagnosed with marasmus and kwashiorkor (severe malnutrition). After revision of both the lip- and tongue-ties, supplementation with pasteurized human milk donor, and good complimentary feeding the babies finally reach an optimal growth and development. Learn more about how these two cases were managed to bring the babies back to health.

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Presentations: 10  |  Hours / CE Credits: 10  |  Viewing Time: 8 Weeks
Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 8 Weeks
Hours / Credits: 1 (details)
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Dr. Martin Kaplan was born in Chelsea, Ma. He completed his undergraduate degree at The University of Massachusetts and then attended Tufts University School of Dental Medicine. After earning his D.M.D. degree he completed a pediatric residency at Montefiore Hospital in New York.

Dr. Kaplan practices exclusively in Stoughton, MA. He continues to take update his laser education by regularly attending the Academy of Laser dentistry Annual meeting where is also contributes as a lecturer ans laser safety officer.  He is one of only a handful of pediatric laser dentists who utilizes lasers for the treatment of infants with breastfeeding issues related to frenum attachment problems.

He is a member of the:

•             American Academy of Pediatric Dentistry

•             Massachusetts Academy of Pediatric Dentistry

•             American Dental Association

•             Massachusetts Dental Society

•             Academy of Sports Dentistry

•             Academy of Laser Dentistry

Academy of Breastfeeding Medicine

When not practicing dentistry he enjoys Karate and has attained the level of 4th degree black belt.

Abstract:

There will be an explanation of the science of laser physics that is easily understandable as it applies to the selection of proper types of lasers. There currently are 3 main wavelengths that can be used for laser surgery. An explanation of how these wavelengths are applicable and how they determine outcomes for infant tissue interaction for laser surgery will be presented in a slide presentation and through videos. The physics of lasers will then be translated to clinical reality through the presentation of various clinical cases which will allow the group to better understand how they can interpret post-surgical results and how the various lasers do interact differently. The tissue healing process of the tissue with the laser wavelengths will also be reviewed and related to the active wound management methods that are suggested. There will be a review of assessment for how the provider of laser surgery selects the setting for his applications in surgery. Through the entire presentation, multiple slides will effectively clarify the mystery behind the true science of the laser surgeries which our patients are receiving.

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Presentations: 5  |  Hours / CE Credits: 5  |  Viewing Time: 4 Weeks
This presentation is currently available through a bundled series of lectures.