The women in this study described a somewhat harrowing journey, which was at odds with the natural experience they had anticipated. They encountered health professionals who were found to have limited knowledge of tongue-tie and its potential effect on breastfeeding and were unable to provide appropriate advice concerning their breastfeeding difficulties. However, following treatment with frenotomy, their breastfeeding experience improved dramatically. The reported incidence of tongue-tie is significant, and early identification and prompt and effective management would contribute to improved breastfeeding.
With this issue, JHL is introducing a new, regular feature: the Roundtable Discussion, where we ask experts to share their informed opinions on a hot topic in lactation practice and/or research. In this issue, we are addressing the cutting edge field of ankyloglossia or "tongue-tie." Our panel consists of pediatric, nursing, and International Board Certified Lactation Consultant (IBCLC) experts from hospital and community settings in the US and Australia. How Is the Infant with Tongue-Tie Usually Identified in Your Setting? Philipp: I direct the well baby unit at an inner city, Baby-Friendly hospital in the US, with approximately 2500 births per year. We routinely check for tongue-ties during nurse and physician admission exams. Hazelbaker: As a private practice IBCLC in the US, I have infant clients ranging from 2 days to 5 months. I screen every baby who comes into my office for care using the Hazelbaker Assessment Tool for Lingual Frenulum Function. 1 In this way, I quickly rule out or confirm tongue-tie as the cause or an aspect of the presenting breastfeeding issue. Edmunds: When a mother presents to 1 of our 4 drop-in community child health breastfeeding clinics in Queensland, Australia, with her infant, the lactation consultant would undertake a full assessment of the breastfeeding including observation of a breastfeed. If the mother identified latching difficulties, sore nipples, frequent breastfeeding and concerns about the infant not maintaining a latch to the breast, they would check in the infant's mouth for tonguetie. Tongue-tie may also be identified by any of our child health nurses in our community drop in well baby clinics or when they are seen as part of our home visiting program for high risk clients. Murphy: Every newborn at our Naval Medical Center in the US receives 1 or more assessments by experienced residents and staff before discharge and again in the Pediatric Clinic Newborn Follow-up Clinic, including assessment for tongue-tie. IBCLC assessment is done on most newborns with feeding concerns before discharge. Lactation trained RN/LVN assessment occurs in the Newborn FU Clinic. Any 428588J HLXXX10.
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