Seminar Report - Tongue Tie and Breastfeeding

 My goodness it was a lot of work organising a seminar. I should start by saying that when I planned it I really didn't think I'd have 110 attendees . That is the level of interest in this issue in Ireland . We had IBCLCs , Midwives, nurses, dieticans , SLTs , GPs , paediatricians , Cuidiu breastfeeding Counsellors and La Leche League leaders . The wonderful thing about it was that we had IBCLCs from the UK travel over to hear Catherine Watson Genna . Some of these IBCLCs are dividing tongue ties on a daily basis . So we had a wealth of expertise in the room.
The day went off beautifully, all kept to time and there was lots of discussion .

Look at what I can do with my new improved tongue ! One of our Irish babies post frenotomy . 

So here's the things i learned....

  • The main thing that seems to be important with tongue function and breastfeeding  is not extension but elevation.  If the baby's tongue can elevate over half way up in the oral cavity when the mouth is open - they may be ok.
  • Sucking blisters on the lips particularly a sucking callus on the top lip are a sign that the baby is using their lips to stay attached (vacuum should be with the  jaw and tongue)
  • A pointed pronounced upper lip between lip and nose  (philtrum)  can be a sign of a narrow palate - narrow palates can go along with tongue tie. The tongue shapes the palate in utero, if the tongue doesn't touch the palate it becomes narrow .
  • There are many different ways to spot a posterior tongue tie -  the Murphy Manouvre, looking at the palate, looking at the tongue itself and how it moves . 
  • Sometimes babies are doing just fine but the mum is in a lot of pain - this can be caused by the baby humping its tongue up at the back and compressing the nipple. 
  •  Irish Figures .......  
  • 97%  of Dr Justin Roche's audit sample said there was a marked improvement in feeding within 48 hours of frenectomy .148 questionnaires posted , 83 returned(59%).  
  • Kings College Tongue Tie clinic has a very strict criteria for becoming "Frenulotomy Ready"  . They don't see babies under 3 weeks and they don't see babies that have not had intensive breastfeeding support to try everything else. 
  • Kings College Tongue Tie Clinic have a very strict policy of post frenulotomy wound care. The wound site is massaged or disrupted for up to 14 days post procedure . They have a low reoccurrence or scarring rate (4%).  This seems to be a contentious issue  among practitioners  but the IATP is in agreement that some amount of post frenotomy care /exercises are appropriate . 
  • Cathy Watson Gennas talk on how to help mothers and Babies with Tongue tie to Breastfeed was a gem. Highlight for me was the "breast dent ". Amazingly simple to do but so effective on getting that extra bit of breast tissue into the babies  mouth. 
  • Finally - the last talk was the only one i got to sit and really listen to, infant use of hands during latch. Brilliant!  Essentially babies use their hands to find the breast and latch . Understanding this and telling mums what the baby's behaviour means makes so much sense. This leads to much calmer mothers and lets babies do what they are best at - self attaching . I've been using this all week in my work and its just fantastic.

  First time  running a seminar is a steep learning curve but judging by the evaluations, I might just make it a regular occurrence....  

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