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Posterior Tongue Tie: Confusion, Concerns and Controversies in the Conceptualization, Definitions, Diagnosis and Treatment of Problems of Tongue Mobility Affecting Breastfeeding Babies

by Christina Smillie, MD, FAAP, IBCLC, FABM
  • Duration: 60 Mins
  • Credits: 1 CERP, 1 L-CERP
  • Learning Format: Webinar
  • Handout: No
  • Origin: GOLD Learning
Abstract:

A growing literature and widespread clinical experience support the role of simple frenotomy in improving breastfeeding function for infants with restrictive anterior frenula. The diagnosis and management of restricted tongue mobility and function involving the posterior tongue, however, remains confusing and controversial. Since Betty Coryllos’ seminal work just over a decade ago, subsequent literature has been limited. Definitions, diagnosis, indications for intervention, management choices and anatomic factors predictive of positive outcomes elude us. Over- and under-diagnosis can both lead to adverse outcomes. This presentation will look at these concerns through the lens of known infant anatomy and oral function in breastfeeding, the available literature, as well as the shared clinical experience and observations of those in the field.

Learning Objectives:

Objective 1: Describe how the hyoid bone, and the various muscles that attach to it, affect tongue mobility and function
Objective 2: Describe the history of the diagnosis of submucosal tongue tie, and the level of research we currently have about diagnosis and treatment
Objective 3: Identify the differential diagnosis of submucosal tongue tie, including potential confounders, and describe the risks associated with both under- and over- diagnosis