There is no one-size fits all approach when it comes to you and your baby. I have seen this scenario countless times, someone is having breastfeeding difficulties and infants exhibit symptoms, so they go onto a Facebook group to describe what is going on. A commenter (or four) says your baby probably has a tongue tie or a lip tie. Mom now feels stressed and alone and rushes to “fix” the problem. The problem here is that there may not even be a tongue or lip tie – it cannot be evaluated by a random mom on the internet. Also, there are many options when it comes to managing symptoms or evaluating next steps to a tongue tie release. It used to look like a quick and easy procedure without much follow up needed. Now, we are seeing better outcomes with proper pre and post-op management. We are also seeing many parents opt to not do a release and they manage through symptoms and compensations.
A conservative approach to tongue tie procedure in infants involves carefully assessing the need for intervention and opting for less invasive treatments first, if appropriate. Here’s a detailed outline of what this approach typically entails:
1. Thorough Assessment by a Specialist
Before considering any procedure, it’s crucial for an experienced healthcare provider, such as a lactation consultant, to conduct a comprehensive assessment. In fact, IBCLCs are the only healthcare professionals trained to support both mom and baby. A thorough assessment involves:
- Clinical Evaluation: Examining the baby’s tongue mobility and function during breastfeeding or bottle feeding.
- Assessment of Symptoms: Determining if the lip or tongue tie is causing issues such as difficulty latching, poor milk transfer, or maternal nipple pain.
- Considering Other Factors: Taking into account the overall health and development of the infant, as well as the mother’s breastfeeding goals.
2. Non-Invasive Management Strategies
If the tongue tie is not significantly impacting breastfeeding or other functions, a conservative approach may involve:
- Positioning and Latching Techniques: Educating parents on optimal breastfeeding positions and techniques that can compensate for the tongue tie.
- Feeding Support: Providing guidance on feeding schedules, techniques to improve milk transfer efficiency, and monitoring the baby’s weight gain.
- Oral Exercises: Recommending exercises or massages to improve tongue mobility and function.
- Body work: The term body work is broad, but overall can be different modalities of fascial movement to relieve bodily tension
3. Monitoring Progress
After implementing non-invasive strategies, it’s essential to monitor the baby’s progress closely:
- Regular Follow-Up: Schedule follow-up appointments to assess feeding progress and any changes in symptoms.
- Parental Support: Offer ongoing support and guidance to parents to ensure they feel confident in managing any challenges related to feeding.
4. Considering Intervention if Necessary
If conservative measures do not sufficiently resolve the issues caused by the tongue tie, or if the condition is severe and impacting the baby’s ability to feed adequately, then a more invasive procedure may be recommended:
- Frenotomy or Frenectomy (Tongue Tie Release): This procedure involves a laser or scissor cut of the frenulum to release the tongue tie.
- Frenuloplasty: In some cases, a more extensive release of the frenulum may be necessary, performed under local anesthesia, often with sutures to heal after. This is done on older kids and adults.
5. Educating and Empowering Parents
Throughout the process, it’s crucial to provide clear, evidence-based information to parents:
- Informed Decision-Making: Help parents understand the risks, benefits, and alternatives to any procedure recommended.
- Emotional Support: Address any concerns or anxieties parents may have about the procedure or their baby’s feeding difficulties.
6. Collaborative Approach
A conservative approach often involves collaboration among healthcare providers, including body workers, lactation consultants, and pediatric dentists or otolaryngologists (ENT specialists). This ensures that all aspects of the infant’s care and feeding challenges are addressed comprehensively.
These providers should come together to help determine the optimal timing of interventions needed and educate families together.
Of course, we do not live in a perfect world, so often times providers will not be as collaborative as would be helpful, so this should be a determining factor when choosing a new provider for the team.
Conclusion
By taking a conservative approach to tongue tie procedures in infants, healthcare providers prioritize the least invasive methods first while ensuring that the baby’s feeding needs and overall development are carefully monitored. This approach aims to balance the potential benefits of intervention with the risks associated with any procedure, ultimately promoting the best outcomes for the infant and supporting successful breastfeeding when possible.
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