Understanding the Complexities of Tongue Tie: 2020 Updates
- Duration: 60 Mins
- Credits: 1 CERP, 1 L-CERP
- Handout: Yes
Abstract:
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 under treatment on the other.
Purpose
• 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
• To share a conservative clinical thinking process
• To examine the effects of frenotomy on breastfeeding and nipple pain
• To compare the effect of frenotomy on anterior verses posterior tongue ties.
Approach
The discussion will focus on the clinical dilemmas regarding releasing posterior tongue ties and their implications for breastfeeding.
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.
Conclusions
Frenotomy is a predictable procedure for anterior tongue tie. However with posterior tongue ties, the outcome of nipple pain and breastfeeding latch are influenced also by different factors.
Learning Objectives:
1. Distinguish between anterior and posterior tongue tie based on the updated literature.
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.
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.
