Speaker Type: Tongue-Tie, Tongue Tie Symposium 2022
Country: United States
Biography:
Dr. Agarwal went to medical school at All India Institute of Medical Sciences, AIIMS, in New Delhi, which is the premiere institution for medical training in India. After which, he came to the United States for his Pediatric Residency at the University of Texas Medical Branch at Galveston. Subsequently went on to join the Pediatric Nephrology fellowship at University of Florida at Gainesville. Under the program, he also conducted bench research at Ohio State University. Dr. Agarwal worked on the Eastern Shore of Virginia for eight years in general pediatrics before moving to Arizona to establish Agave Pediatrics in 2005. Over the years Dr. Agarwal has developed his own style of practicing pediatrics, which is strongly supportive of natural ways of taking care of children and emphasis on breastfeeding. During his practice, he realized that one of the biggest impairments in breastfeeding was the presence of labial and lingual ties. Having performed some procedures during medical school, he re-educated himself about the procedure and started performing them in 2007. In the last 15 years, Dr. Agarwal has performed more than 18000 frenotomies. Now, along with a busy clinical practice, he has made it his goal to spread the awareness about the issues related to labial and lingual ties to pediatricians, lactation consultants, doulas, midwives -everybody who helps mothers with the process of breastfeeding and in taking care of children with feeding and speech difficulties.
According to the American Academy of Pediatrics, it is a high priority to advocate for the support of breastfeeding. Numerous studies have clearly demonstrated the significance of breastfeeding in a child’s overall health and wellness. Unfortunately, the presence of a tongue tie can pose a major obstacle for healthy breastfeeding. Ankyloglossia (tongue-tie) has long been a topic of much controversy, concern, and debate. Tongue-ties can cause problems with breastfeeding because the tongue is restricted in its natural movement of sucking and feeding. Research indicates that a frenectomy is a safe and effective treatment that usually helps improve breastfeeding. However, surprisingly, pediatric clinics across the U.S. do not routinely perform lingual and/or frenectomies. In this lecture, Dr. Agarwal discusses the history of tongue ties and the clinical presentation of symptoms commonly experienced by an infant who is tongue-tied and/or a mother trying to breastfeed with a tongue-tied child. He also details how to identify tongue ties, determine whether a frenectomy is needed, frenectomy treatment options, and associated aftercare.
Frenectomy has become an increasingly more common procedure since the resurgence of interest in breastfeeding. Patient selection and anticipatory guidance provided to the family are key to success in reaching their goals. An honest discussion about the indications for doing the procedure and providing them with resources preemptively help in establishing trust and the future success of the procedure. After the procedure the care of the baby and the site are very intimidating to families and support at that time is vital to the success of the procedure. The post procedure experience can vary widely and to an extent depends on the family’s readiness. It is very important that post procedure be discussed before the procedure and support given after the procedure. Ultimately, the pre and post procedure interventions make the experience wholesome and conducive to successful breastfeeding.
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