Pre & Post Care Online Course(s) & Continuing Education
Access the latest clinical skills and research for Pre & Post Care for Tongue-tie, Lip Tie & Structure professional training. These Pre & Post Care online courses provide practice-changing skills and valuable perspectives from leading global experts. This Pre & Post Care education has been accredited for a variety of CEUs / CERPs and can be accessed on-demand, at your own pace.
Building a Clinical Tongue-Tie Care Plan Families Can Work With
Gina has been assisting breastfeeding mothers for over 20 years, and now through telehealth all over the world. She knows that while most pregnant mothers expect to breastfeed, very few receive proper preparation for the difficulties and the rollercoaster of emotions when there are problems.
When Gina had her first baby, like many new mothers she was overwhelmed by conflicting information: at the hospital, the pediatrician’s, and from well-meaning friends and family.
Her appreciation of the volunteer support she received led her to want to “pay it forward” and help others. She first trained as a volunteer LLL Leader in Houston, Texas, then as a birth doula in Amsterdam, The Netherlands, and finally sat for the exam to become an IBCLC in Seville, Spain. She continues to lead monthly breastfeeding support meetings online and in-person.
Gina believes that all mothers deserve quality emotional and educational support. It should not be just a matter of good luck. She's dedicated to giving effective guidance and caring support with real results. Her greatest satisfaction is the joy of seeing that look on both mothers’ and babies’ faces that says: Just what I always wanted!
When tethered oral tissues (TOTS) are impacting feeding, a care plan must be tailored to the unique circumstances of the parent(s), the baby and the reality of their environment. Parents are often feeling overwhelmed and desperate and from the moment of our initial consult, our nurturing care and guidance provide safety and relaxation. When parents feel understood, they often cry and release a massive amount of stress. The flow of oxytocin and endorphins can soothe their emotional pain as they begin to trust that help is possible. We calmly identify areas needing attention, we prioritise them, and we find out what is most easily doable for the parent(s) among the top priorities. Each step of the care plan offers choices (in regards to feeding, positioning, milk supply, exercises, etc) that will positively impact both the wellbeing and the feeding experience. We help parents to understand that feeding is a whole body activity and that an improvement in any area gives ripples of improvement in the others. We make adjustments as needed, and the changes begin to flourish. We replace fear and confusion with confidence and flexibility. Parents understand “the why” of each step and begin to enjoy that they themselves are driving the positive change!
Annette Leary
Annette has been a maternal child health registered nurse for over 36 years. She took her first IBCLC exam in 1995. She started her craniosacral therapy Upledger training in 2015, and continued to take advanced classes yearly as well as serving as a teacher's assistant. Annette owns two businesses, Orlando Lactation and Wellness Services and is a partner business owner of Baby BLISS: Central Florida Feeding Collaborative. She enjoys working with families, earning their trust and teaching them how to latch onto parenting through feeding and educational support.
Shifa Shamsudeen
Dr. Shifa Shamsudeen is a Preventive Pediatric dentist with Fellowship in Dental Sleep Medicine from Tufts University and an International Certificant - American Board of Dental Sleep Medicine.
She provides holistic dental care for children from infancy to adolescence. Her field of expertise include functional Tongue tie release, PEDIATRIC DENTAL SLEEP medicine, Orofacial myofunctional therapy and PREVENTIVE PEDIATRIC DENTISTRY.
She is the founder and director of WE LITTLE hospitals for providing preventive dental orofacial care since 2011, providing painless, holistic wellness care.
She is the founder of Institute of craniofacial Myology and pediatric sleep - for training professionals in the field of craniofacial myology. She has trained over 50 dentists and allied health professionals so far.
She is the founder and trustee of THE TONGUE FOUNDATION - A NGO initiated to help babies and mothers through establishing breastfeeding.
Dr. Shifa is the founder of Myoline protocol – a strategically curated myofunctional program that helps align teeth naturally without any extractions. She has successfully helped more than 700 children achieve naturally aligned teeth.
She is also the founder of LITTLE WE – preventive holistic dental care centres at tier 3 cities to make dentistry accessible for everyone.
Justin Roche
Justin is a Consultant Paediatrician who has worked in both the UK and Ireland. He has had an interest in Tongue Ties for over 15 years and has created multi-disciplinary pathways of care. He is Medical Director of the National Tongue Tie Centre in County Tipperary, Ireland which he established with Kate Roche, a Chartered Physiotherapist, in 2017. There he and the team provide comprehensive care for infants, children and adults with tethered oral tissues
Post frenotomy care wound care is a topic that frequently creates confusion and controversy within the health care field due to the lack of research available to guide practice guidelines. Join our expert speakers as they discuss the latest thoughts on post frenotomy wound care including its purpose, current approaches to wound care and how it fits into the bigger picture of post frenotomy care, along with gaps in research that could provide areas for future study.
Game Changers in a Tongue Tie Clinical Protocol
Patricia Díaz L., Woman passionate about accompanying Women and Families through their Conscious and Connected gestational, birthing and parenting journeys. She is a trained Pediatrician, IBCLC and Doula.
Graduated as a Surgeon physician and Pediatric Specialist from the Central University of Venezuela, at the main Children's Hospital of the country; JM de los Ríos.
With more than a decade of experience, Patricia, strongly advocates for Human Lactation Education and Research in innovative fields of interest such as, Oral restrictions and their impact in a Breastfeeding journey and functional orofacial and neurodevelopment. At her private practice in Venezuela, at La Trinidad Medical Teaching Center ( where she is currently the Chief of Pediatrics), she has co-designed a multidisciplinary Tongue Tie Protocol. This multidisciplinary team is integrated by a pediatric surgeon, an Ocupacional therapist, a Phonoaudiologist and a Pediatrician IBCLC who together, with the support of other subspecialties such as neuropediatricians, pediatric dentistry amongst others, manage referrals from all over the country, as well as sharing insights and educational resources through medical conferences for developing childcare professionals.
Topic: Game Changers in a Tongue Tie Clinical Protocol - [View Abstract]
Topic: Slow Weight Gain in the Early Days of Breastfeeding - [View Abstract]
When working with families on the journey of an infant tongue tie diagnosis, we frequently find ourselves in complex scenarios with desperate parents: mothers who have experienced painful breastfeeding, sleep deprivation, frustration and uncertainty due to few results, expressed in the baby's slow weight gain, gastrointestinal symptoms, fussy/sleepy babies and confusing or little guidance from their health providers. Depending on the time these families arrive at our specialized Tongue Tie Protocol, they might present with high and unrealistic expectations regarding a “quick release” of the restrictive lingual frenulum and without a proper understanding of the pre- and post-release requirements that can facilitate optimal results. Our protocol has evolved over the years, refining the elements that have demonstrated better adherence to the recommendations and greater commitment to the pre- and post- release strategy designed by a multidisciplinary team of pediatrician IBCLC, pediatric surgeon and bodywork group integrated by occupational therapist and fonoaudiologist/ speech therapist, who is in charge of guiding orofacial muscle competence. This holistic and integrative vision has allowed us to support families to achieve their breastfeeding goals with greater ease and enjoyment, develop the baby's myofascial competence so that they are not simply compensating, facilitate more fluid transitions to starting solid foods, promote predominantly nasal breathing patterns, and build the potential for more harmonious and functional facial development.
Leslie has been providing lactation support in Central New Jersey for over 18 years - as a La Leche League (LLL) leader since 2002, an IBCLC at Mercer County WIC from 2014 to 2016, and as a private practice IBCLC since 2011.
Leslie grew up in New York and New Jersey. She graduated from Cook College/Rutgers with a BS in Biochemistry, and from Rutgers University/UMDNJ with a PhD in Biochemistry and Molecular Biology. Leslie's difficulties with early breastfeeding, the help she received from LLL, and challenges with returning to work laid the foundation for her understanding of the importance of skilled and compassionate lactation and infant feeding support.
Topic: Getting Feeding Back on Track After Tongue-Tie Release - [View Abstract]
Topic: Untangling the Big Picture of Tongue-Tie Assessment - [View Abstract]
IBCLCs assess chest/breast and bottle feeding skills, as well as infant oral and body structures and motions that contribute to, or inhibit, the process of feeding at the breast/chest or bottle. This presentation will focus on the role of the IBCLC when ties have been released - emphasizing the crucial nature of taking into account what occurs prior to, during and after a tie-release. IBCLCs look at not only the function of an infant’s oral skills and structures, but also the infant’s body as a whole; as well as the emotional and physical experience of the lactating parent, family dynamics, and feeding goals - and using this information to create a manageable plan for the family, adjusting milestones and goals as infant feeding skills and parent goals change; and guiding the possible role of other healthcare providers during a case.
Navigating the Challenges of Tongue-Tie: Counseling and Anticipatory Guidance
Adrienne Guirguis, a board certified lactation consultant has over 25 years experience in helping breastfeeding infants and their families. She began her journey into the world of lactation after struggling to breastfeed her oldest son. She became an accredited La Leche League leader and was able to help babies breastfeed. Her experience with La Leche League led Adrienne to become a International Board Certified Lactation Consultant (IBCLC). She has been board certified for 20 years and has experience with a wide range of problems that may be experienced by new families. Adrienne has worked in hospital for over 10 years and then worked in community health for many years. She is a clinical practitioner, working hands on with families to improve feeding outcomes.
Adrienne continues her lactation education, constantly attending conferences and courses to stay up-to-date on the information and skills needed to benefit those who most need breastfeeding help. In 2022 Adrienne completed the Holistic Integrative/Functional Lactation course, a year long program followed by a residency. This course has increased her skills to provide the best care for the families with whom she works.
Adrienne also is an educator, working within the community to teach others the skills necessary to become lactation counselors and eventually board certified lactation consultants.
Parents with infants who are having breastfeeding issues due to tongue tie, face a complicated journey of conflicting information and differing opinions, complicated care plans and challenging emotions. Providing anticipatory guidance about the education providers receive on tongue tie, the many faceted symptoms of tongue tie for both parent and infant, the functional assessment versus the appearance of tongue and compensatory behaviors are all important for the parents to be able to make informed decisions and successfully navigate their way back to successful breastfeeding. Learn more about how to provide necessary information in a compassionate and useful way to already overwhelmed parents.
Neuromuscular Re-Education and Tension Release as Tools to Optimize Feeding Post Frenotomy
Kate is a Chartered Physiotherapist who specialises in working with babies, children and adults with oral dysfunction.
Having trained at the University of Liverpool in the UK, she worked in both Leeds and Southampton, where she led and delivered the regional neonatal service for pre-term and high-risk infants, before moving to Ireland in 2003. She is a member of the Irish Society of Chartered Physiotherapists and an International Board Certified Lactation Consultant.
Over the years Kate has traveled many times gaining extra training in areas that support her work in the field of oral dysfunction including Feeding Therapy, Orofacial Myofunctional Therapy and Craniosacral Therapy.
Kate and her husband, Dr Justin Roche, own and run the National Tongue Tie Centre in Ireland leading a large multidisciplinary team providing both specialised care and education in tongue tie.
Treatment of tongue tie is multi-faceted. Releasing the structural restriction of Ankyloglossia allows for a change in function but therapy is needed to help this process as habits are already formed, however young the patient. Facilitating new neural pathways will help achieve normal movement patterns in place of compensatory strategies. These compensations cause tension within the body that can block free movement of the oral structures. Tension can also lead to asymmetries which make achieving postural stability difficult. This lack of postural stability or misalignment within the body structures also hinders the fine motor coordination needed for optimal oral motor skills. This talk aims to discuss how to approach treating infants with Ankyloglossia whilst taking all these factors into account.
Post Frenotomy Wound Management and Bodily Autonomy
Effath Yasmin is India's leading Biodynamic Craniosacral Therapist, an award winning International Board Certified Lactation Consultant & a Documentary Film Maker. She is also an International Speaker, an Author & a Bach Flower Practitioner.
Her special interests lie in Infant Oral, Sucking & Airway Dysfunction, Tongue Tie, Birth Trauma, Craniofacial Development and a range of chronic physical and mental dis-eases & quantum energy phenomenon. She applies these sciences into Life Coaching, Inner Child Healing and Parenting. Her approach stems from fundamental truth of human organism is complete and self-regulatory and treatment & counselling approach is by deep listening & true empathy to mind body and spirit rather than by intervention.
She currently sits on several national & international professional boards.
She has spear-headed & dedicated her life to many projects with a central mission of advocacy, education and awareness for integrative multidisciplinary wellness approach worldwide. Her work has been published in the International Journals & a textbook and she writes extensively on print and digital media on the subjects of Breastfeeding, Tongue Tie, Parenting & Health related subjects.
Her international award winning film 'Untying Breastfeeding' exposes the glaring unseen obstacles to Birth & Breastfeeding & early parenting that can help restore motherhood and has been widely celebrated over 1500 Cities worldwide. She is currently pursuing her Ph.D. in Metaphysical Sciences.
Topic: Rethinking Surgical Tools - Infant Frenotomy & Pain - [View Abstract]
Topic: Trauma Informed Care in Clinical Infant Oral Assessment: Understanding Body Autonomy - [View Abstract]
The most talked about discussions amongst parents or professional groups across the world is post frenotomy wound management. In the last 15-20 years of development, the field of oral restrictions has yet to see an evidence-based approach or even just a global consensus on approaches and their efficacy in wound management. Therefore lactation consultants, dentists, and surgeons have been using their clinical reasoning to choose the methods and protocols for individual breastfeeding dyads. Nevertheless, the current unregulated wound management protocols have been often reported as traumatic experiences for infants, parents, and care providers. Additionally, a physical oral examination of an infant during the assessment, evaluation, and treatment, and rehabilitation of oral restrictions is essential and vital in an IBCLC clinical practice. It's often seen as a ‘necessary evil’ in clinical work. Some infants may be at risk of reattachment and/or trauma which can have lifelong impacts such as triggers for past memories, anxiety, distress or discomfort, or even PTSD. This can lead to oral aversion symptoms, complete refusal to latch and breastfeed, turning away from food, and gagging, coughing, and choking. Therefore, a respectable trauma-informed approach to oral examination and wound management is based on the fundamental principles of respect for bodily autonomy ensuing a sense of safety, trust, and connection.
The Elephant In The Room - Bleeding Post Tongue-Tie Division
Sarah is a Registered General Nurse, Health Visitor, International Board Certified Lactation Consultant and Tongue-tie Practitioner with a busy private practice based in Cambridgeshire. Sarah is a founder member and former Chair of The Association of Tongue-tie Practitioners and has written a book for parents and professionals, ‘Why Tongue-tie Matters’. She lectures on infant feeding and tongue-tie nationally and internationally and has her own online course on infant tongue-tie.
Topic: COVID-19 and Implications for Tongue-Tie Division in Infants - [View Abstract]
Topic: Functional Assessment and Differential Diagnosis of Tongue-Tie - [View Abstract]
Topic: Is This a Tongue-Tie: How Do We Decide? - [View Abstract]
Topic: The Elephant In The Room - Bleeding Post Tongue-Tie Division - [View Abstract]
This presentation explores professional and lay perspectives on bleeding post tongue-tie division. It will examine what constitutes abnormal bleeding and why this may occur. Risk assessment and reduction will be discussed. Management strategies that have been found to be effective, along with the development of guidelines on bleeding by the Association of Tongue-tie Practitioners will be described.
Understanding the Variations of Active Wound Management and Neuromuscular Re-Education
Robyn Merkel-Walsh, M.A., CCC-SLP/COM® is a Licensed Speech Pathologist with over 25 years of experience. She is employed full time by the Ridgefield Board of Education and runs a private practice in Ridgefield, NJ. She is also an author, lecturer, and consultant for TalkTools® . Robyn specializes in Oral-Placement, feeding, and orofacial myofunctional disorders in the pediatric population. Her publications include, SMILE (Systematic Intervention for Lingual Elevation), Art Talk, Handy Handouts, OPT-S Kit, and she co-authored Sensory Stix, A Sensory-Motor Approach to Feeding, Functional Assessment and Remediation of Tethered Oral Tissues and Oral Placement Therapy Goals for Speech Clarity. She has also written several articles for the TalkTools® website, The ASHA Leader, and Advance Magazine for Speech Pathologists. She has been published five consecutive years at the annual convention of the American Speech-Language and Hearing Association. Robyn received both her undergraduate and graduate degrees from Montclair State University, where she was later invited to be an adjunct/clinical supervisor. She has also taught classes and/or as a clinical supervisor for: Bergen Community College, Seton Hall University and Malloy College. She is a member of American Speech-Language and Hearing Association, American Academy of Private Practice in Speech Pathology and Audiology, New Jersey Education Association, International Association of Orofacial Myology, Oral Motor Institute, Ankyloglossia Bodyworkers , International Consortium of Ankylofrenula Professionals and The Bergen County Apraxia Association. She served a term on the New Jersey Speech and Hearing Association Board of Directors and was the private practice co-chair. She is also the Board Chair of the Oral Motor Institute and the Associate Editor of the International Journal of Orofacial Myology.
There is a better understanding within the fields of medicine and dentistry, lactation, speech-pathology, occupational and physical therapies that functional assessment and treatment is critical for optimal lingual, buccal and labial frena releases. Semantics and terminology however are often confused regarding a treatment protocol. Post-op TOTs care has two phases: 1) Active Wound Management to maintain the integrity of the wound and avoid scarring and re-attachment and 2) Neuromuscular Re-Education to address the underlying muscle and motor- based deficits that are secondary to the oral restriction(s). Both stages of treatment must be considered. This course will outline the two stages, review national scopes of practice for various professionals involved in TOTs care and discuss guidelines for referrals to team members. Specific techniques will be reviewed and categorized as to which stage of treatment is being addressed, which sometimes may overlap.
Will It Hurt? Frenotomy Aftercare Strategies to Optimize Healing Outcomes for the Newborn
Melissa Cole is a board-certified lactation consultant, neonatal oral-motor assessment professional and clinical herbalist in private practice. Melissa is passionate about providing comprehensive, holistic lactation support and improving the level of clinical lactation skills for health professional. She enjoys teaching, researching and writing about wellness and lactation-related topics. Her bachelor’s degree is in maternal/child health and lactation and her master’s degree is in therapeutic herbalism. Before pursuing her current path, Melissa’s background was in education and cultural arts, which has served her well in her work as a lactation consultant and healthcare educator. She loves living, working and playing in the beautiful Pacific Northwest with her 3 children.
Topic: A Mindful Approach to Infant Tongue-Tie Care - [View Abstract]
Topic: Beyond Fenugreek: An Individualized Approach to Dietary and Herbal Galactagogues - [View Abstract]
Topic: Beyond the Basics of Latch: Support Strategies for Helping Babies when the Basics Aren’t Enough - [View Abstract]
Topic: Common Infant Digestive Health Concerns and Useful Support Strategies - [View Abstract]
Topic: Connection and Care: Virtual Support for Tongue-Tied Infants - [View Abstract]
Topic: Feeding is Movement: Activities for Supporting Optimal Infant Oral Function - [View Abstract]
Topic: Infant Gut Health: Common Concerns and Useful Support Strategies - [View Abstract]
Topic: Infant Oral Assessment: Exploring Anatomy and Function Beyond the Frenulum - [View Abstract]
Topic: Low Milk Production Detective Work: Assessment and Care Plan Considerations - [View Abstract]
Topic: Nature’s Nurturers: Plant Medicine for Perinatal Mental Health - [View Abstract]
Topic: New Thoughts on Infant Pre and Post-Frenotomy Care - [View Abstract]
Topic: Placenta Medicine as a Galactogogue: Tradition or Trend? - [View Abstract]
Topic: Thinking Critically About the Use of Clinical Lactation Tools - [View Abstract]
Topic: Will It Hurt? Frenotomy Aftercare Strategies to Optimize Healing Outcomes for the Newborn - [View Abstract]
There are a few emerging theories and clinical practice ideas when it comes to frenotomy aftercare for the newborn. Clinicians and families sometimes struggle with the idea of how to balance efficient post-frenotomy care while minimizing stress and discomfort of the newborn. While the evidence strongly points to the benefit of frenotomy for tongue-tied neonates, there is little published evidence regarding best aftercare practices. During this presentation we will explore the neonatal experience of pain along with pain management and oral healing strategies. We will also discuss the impact of stress on wound healing and focus on ways to help keep babies calm and happy through the recovery process. For families coping with a tongue-tied baby, it is often a physical and emotional roller coaster ride. This presentation will help provide a well-rounded view of frenotomy aftercare issues as well as clinical, care strategies to optimize healing and feeding for the newborn.
