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

by Gina Weissman, DMD, RN, IBCLC, FABM
  • Duration: 60 Mins
  • Credits: 1 CERP, 1 R-CERP
  • Handout: Yes

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.

Learning Objectives:

Objective 1: Distinguish between anterior and posterior tongue tie based on the updated literature;

Objective 2: Describe physical and functional characteristics that lactation specialists must assess when considering whether to refer an infant for evaluation and possible treatment of posterior tongue tie; and

Objective 3: List components that must be included in a lactation management plan whenever a lactation specialist is concerned that an infant may have a posterior tongue tie.

Presentations: 2  |  Hours / CE Credits: 1  |  Viewing Time: 2 Weeks
Presentations: 29  |  Hours / CE Credits: 27.0  |  Viewing Time: 8 Weeks