Tongue & Lip Tie Assessment Online Course(s) & Continuing Education
Access the latest clinical skills and research for Tongue & Lip Tie Assessment for Tongue-tie, Lip Tie & Structure professional training. These Tongue & Lip Tie Assessment online courses provide practice-changing skills and valuable perspectives from leading global experts. This Tongue & Lip Tie Assessment education has been accredited for a variety of CEUs / CERPs and can be accessed on-demand, at your own pace.

A Case for Clipping, a Case for Waiting: Difficult Decisions in Clinic

Dr. Gina Weissman began her career as a dentist, receiving her training at The Hebrew University Hadassah Medical School, Jerusalem. She is also a RN nurse and has been working as an IBCLC, Certified Lactation Consultant, since 1999. She teaches courses in human lactation for both medical professionals and future lactation consultants, mentoring them in preparation for the international exam of the IBCLC. Dr. Weissman councils mothers and releases tongue ties at her private breastfeeding clinic, HalavM. She is an expert in teaching mothers Instinctive Breastfeeding and the author of Mother's Milk, a Video Guide to Breastfeeding (Hebrew/Arabic/English).Dr. Weissman is an international lecturer and the president of the Israeli Association of Certified Lactation Consultants.She lives in Israel with her husband Amir and four sons.
Topic: Understanding the Complexities of Tongue Tie: 2020 Updates - [View Abstract]
Institutions: Department of Nursing, Laniado Hospital, Netanya, Israel, Halav-EM Breastfeeding Clinic
Background: As far as anterior tongue tie is concerned, there is a growing, vast body of knowledge that has been validated. As for posterior tongue tie, the scientific evidence is lacking and the assessment tools are not uniform among practitioners.
Medical diagnoses are not part of the scope of practice of Lactation Consultants. Hence, there is a lot of confusion among professionals (both Drs and Lactation Consultants), resulting in over diagnosis and over treatment on the one hand, and also under treatment on the other.
Aims: To present a unique perspective of an experienced Lactation Consultant who is also a dentist, experienced in diagnosing and treating various types of tongue ties.
Narrative: The discussion will focus on the clinical dilemmas regarding releasing posterior tongue ties and their implications for breastfeeding in newborns as well as in older babies.
Clinical cases of babies with posterior tongue ties will be shown to demonstrate how exclusive breastfeeding can be achieved in clinical cases with posterior tongue ties that were not released. Cases of anterior and posterior tongue ties that had been released although breastfeeding was going well will also be shown. In these cases, additional factors were taken into account, such as the palate structure and the additional consequences that Ankyloglossia may have later in life.
Conclusions: In some cases of posterior tongue ties, good breastfeeding counseling can make the action of releasing the tongue redundant. However, then we are left to consider conservatively what other effects Ankyloglossia may have on our body.

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Beneath the Surface: Anatomy and Physiology and How These Influence the Approach to Frenectomy

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.
Topic: Unraveling Tongue-Tie: Surgical Insights and Lifelong Health Implications - [View Abstract]
The management of tongue tie has many approaches. In this presentation we will explore the anatomy and physiology of normal tongue frenulae and that of ankyloglossia. How the structures affect function and how to manage them to optimise function. We will also discuss the problems that can be seen following incomplete release and reattachment. We will also cover complications during surgery and management options.

Beyond Breastfeeding: The Long Term Implications of Tongue-Tie in Our Adult Patients

Sarah Hornsby is a registered dental hygienist, orofacial myofunctional therapist, speaker, mentor, and entrepreneur. She’s the founder and creator of MyoMentor, a comprehensive mentorship and online educational platform for myofunctional therapy with over 900 graduates as of August 2022. She’s passionate about merging technology into patient care and has been a pioneer in utilizing telehealth practices in the field of myofunctional therapy since 2014. Sarah is a provider advocate as much as she is an advocate for her patients. Her goal is to empower hygienists and dentists to elevate the standards of care by helping their patients through healthy breathing, airway dentistry, myofunctional therapy, and multi-disciplinary collaboration. She opened Faceology, her private myofunctional therapy practice, in 2010 and today it is a thriving telehealth speciality clinic with a focus on adult patient populations and complex treatment cases. Although Sarah has been a myofunctional therapist for over 10 years, it was actually her own health journey that led her down the path to help her patients.
When it comes to addressing tongue-ties in medicine and dentistry, there is a large emphasis on treating infants in order to achieve optimal breastfeeding. But what happens to the babies who grow into children and adults without addressing their tethered oral tissues, and they end up as adults with tongue-ties? This presentation will discuss the challenges and symptoms that tongue-tied adults face later in life due to restricted lingual frenums. Knowledge of long-term implications is an important part of clinical teaching when explaining tongue-tie to caregivers or colleagues.

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Catherine Watson Genna BS, IBCLC is an International Board Certified Lactation Consultant in private practice in New York City. Certified in 1992, Catherine is particularly interested in helping moms and babies breastfeed when they have medical challenges and is an active clinical mentor. She speaks to healthcare professionals around the world on assisting breastfeeding babies with anatomical, genetic or neurological problems. Her presentations and her writing are enriched by her clinical photographs and videos. Catherine collaborates with Columbia University and Tel Aviv University Departments of Biomedical Engineering on research projects investigating the biomechanics of the lactating nipple and various aspects of sucking and swallowing in breastfeeding infants. She is the author of Selecting and Using Breastfeeding Tools: Improving Care and Outcomes (Praeclarus Press 2009) and Supporting Sucking Skills in Breastfeeding Infants (Jones and Bartlett Learning 2008, 2013, 2017) as well as professional journal articles and chapters in the Core Curriculum for Lactation Consultant Practice and Breastfeeding and Human Lactation. Catherine served as Associate Editor of the United States Lactation Consultant Association’s official journal Clinical Lactation for its first seven years.
Topic: Breastfeeding Strategies for Tongue-tied Infants - [View Abstract]
Topic: Critical Assessment of Apparent Tongue-Tie - [View Abstract]
Topic: Introduction to Cervical Auscultation - [View Abstract]
Topic: Lactation Support for Infant Biomedical Challenges - [View Abstract]
Topic: Organization of tongue movements before and after frenotomy for posterior tongue-tie: an Ultrasound analysis - [View Abstract]
Topic: Positioning and Latch for Breastfeeding - [View Abstract]
Topic: Ultrasound Analysis of Sucking: Tongue-Tie and Confounders - [View Abstract]
Topic: Using Breastfeeding Supplementers - [View Abstract]
Tongue tie is one potential cause of breastfeeding difficulties, but most authorities fear that frenotomy is overused. This presentation explores research on the role of the tongue during normal breastfeeding; briefly reviews validated assessment tools, and proposes other management, structural and medical issues that impact tongue mobility and feeding.


Renee Beebe has been working in the field of lactation since the birth of her first child in 1990--as a La Leche League Leader, postpartum doula and IBCLC. She draws from her background in education and child development every time she works with a family. Since becoming an IBCLC in 1997, Renee has supported families through home, hospital and clinic visits in the Seattle area, and telehealth consultations internationally. She has spoken for a variety of organizations and is thrilled to be working with GOLD again!
Renee has developed a special interest in tongue tie and helped develop a tongue-tie clinic. She has assisted with over 2000 frenotomies with scissor and laser release providers. She understands how confusing the issue of tongue tie can be for families, which is what lead her to write her book, Fit to be Tied.
When she's not busy with babies, Renee enjoys all that the Seattle area has to offer; including hikes, concerts, art museums and hanging with her two grown daughters, their partners and her new toddler grand baby! Travel happens whenever possible and usually includes a lactation conference and gaining a global perspective on all things breastfeeding.
Topic: Helping Parents Navigate the Roller Coaster Ride of Tongue-Tie and Breastfeeding - [View Abstract]
Topic: In the middle: When your advice differs from the Dr's - [View Abstract]
When we think of assessing for tongue tie, we usually think of an exam that includes touch. Palpating the tissue quickly gives us valuable information. Do we feel tension? What is the tongue doing during the exam? But what if we are not able to be in the same room as the dyad? Or what if our role or training does not support inserting our finger into a baby’s mouth? OR what if the parents do not give permission for that type of exam? Even in these situations it is still possible to gather information needed to make recommendations regarding tongue tie. This presentation will teach you how to how to use the skills you already have to do an evaluation–even if you cannot touch the baby.

Foundations of TOTS Assessment: Anatomy, Appearance, and Function

Lisa Lahey RN, IBCLC, OMT has worked for 23 years in maternal child health as a nurse and lactation consultant in L/D, postpartum, newborn nursery, NICU, and perinatal education. Lisa is currently working on her master's degree for Family Nurse Practitioner. An IBCLC for 20 years, Lisa has a special interest and expertise in tethered oral tissues. Lisa’s private practice Advanced Breastfeeding Care provides home visits or office consults for complex feeding issues as well as joyful breastfeeding. Lisa also provides myofunctional therapy to babies, children, and adults in a functional orthodontic office. Lisa is a contributing author to the book Tongue Tied. Lisa enjoys teaching assessment fundamentals and oral exercises when she lectures at conferences and courses. Clinical photography and nature photos are also a favorite hobby. Most of all, she is a mom to five children (all were breastfed) who keep her busy and remind her daily of life’s joys and treasures traveling and hiking with her family to unplug from a busy pace in life.
The IBCLC must develop and expand knowledge of the 3 foundations key to TOTs assessment which are anatomy, appearance, and function. This talk will review anatomy and physiology concepts, explore appearance of frenulums, and discuss current functional screening tools that can be utilized for assessment.

Functional Assessment and Differential Diagnosis of Tongue-Tie

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]
In order to advance the care of tongue-tied babies, we must fully examine the concept of tongue function as opposed to tongue appearance. This presentation explores how we can identify deficits in tongue function that will impact feeding. It will review the research on how babies use their tongues during feeding and examine the different assessment tools available and the appropriate use and relevance of these tools. It will also discuss other factors which may impact tongue function and feeding which need to be considered when making a diagnosis of tongue-tie and recommending division.

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.

Identifying and Addressing Compensations and Inefficient Movement Patterns in the Tongue-Tied Baby

Allyson is a physical therapist, International Board Certified Lactation Consultant and co-owner of Nurture Columbus, in Columbus, Ohio. She completed a Bachelor's degree in Biology from Ohio University in 1997, and Master of Physical Therapy degree from Northwestern University in 1999. After having a child in 2007, she volunteered as a La Leche League leader. She discovered a love for supporting new parents but a gap in lactation care, which led her to become an IBCLC in 2014.
Her clinical approach to identifying and overcoming feeding challenges is unique with physical therapy foundations in posture, movement and reflexive function. Through presentations she endeavors to engage IBCLCs to know more about movement as related to human lactation, and physical therapists to learn about breastfeeding as related to human development. As past-president (2019-2021) of the Ohio Lactation Consultant Association, she also advocates for equitable access to and health plan coverage for lactation care. Publications include co-authorship in the Journal of Human Lactation (2022), American Journal of Maternal/Child Nursing (2021), and Clinical Lactation (2020).
Topic: Identifying and Addressing Compensations and Inefficient Movement Patterns in the Tongue-Tied Baby - [View Abstract]
Topic: Neuroanatomy and Biomechanics: Breastfeeding as a First Movement Milestone - [View Abstract]
Knowledge of whole-body movement, reflexes, and posture as related to breastfeeding is essential to IBCLC competency. A newborn human emerges from a physiological flexed position from which gradual unwinding occurs over months. Functional breastfeeding facilitates unwinding, requiring upper body extension, reflexive movement, and reciprocal posturing between each breast. Compensatory breastfeeding inhibits movement progression, coordination of upper body posture, lower body stability and the reflexive motion expected for functional feeding. Examples of compensations during feeding may include chomping, limited jaw gaping, excessive jaw excursion, clicking, arching, burrowing, and whole-body restlessness. Signs of compensations can include lip blistering, favoring one side, head turning preference, and overactive or underactive reflexes. All should be assessed and optimized in preparation for oral restriction assessment. This presentation will focus on improving posture, infant-led/reflexive breast attachment, feeding frequency/motor memory, and emotional well-being before and after frenectomy. Identifying and addressing whole body compensations and inefficient movement patterns will be reviewed. Resources for expanding expertise as well as when care beyond one’s own expertise may be necessary will be provided. Presented by an IBCLC/physical therapist, breastfeeding as a vital sign and first movement milestone in need of more definition as such across the healthcare continuum will be underscored.


Dr. Ankita Shah is a leading Airway Focused Dentist. She is also the President of the India Airway Co-LAB Chapter initiated by AAPMD, New York & The Breathe Institute, Los Angeles. Dr. Ankita is also the only Indian Ambassador to be trained by the renowned ENT & Sleep Surgeon Dr. Soroush Zaghi. The Tongue Tie & Sleep Institute headed by her focuses on providing a comprehensive, holistic and multidisciplinary approach to all problems Tongue Tie, Airway & TMJ. She wishes to change the way in which medicine has approached problems in the past and provide patients with a redefined experience to dentistry.
What are tethered oral tissues and what is the role of fascia? Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. How is the fascial system connected to TOTS? The condition of tongue-tie and lip-tie exists on a continuum with variable visibility and symptoms differently across the body through different age groups. Some restrictions, mainly anterior or “classic” tongue tie, are highly visible and easier to detect. However, “posterior” or submucosal tongue-ties are often more challenging to diagnose. Through this session, we will explore a detailed dissection of what is fascia and how the concept of tongue ties has evolved and changed with the role of fascia and its impacts with TOTS. It takes a village of specialists to treat this challenging problem. We will learn how we can help prevent a vicious circle of problems if treated early with a holistic integrative approach.

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