In this episode of Behind the Latch, Margaret Salty explores the complex topic of tongue-tie (ankyloglossia) and its impact on breastfeeding. Tongue-tie can be a challenging condition for both lactation consultants and families, often leading to significant breastfeeding difficulties. Margaret reviews the latest evidence, shares insights from authoritative bodies, and provides practical advice for lactation consultants navigating this common but sometimes controversial condition.

Key Points Covered:

1: Overview of Tongue-Tie

• Introduction to tongue-tie, its prevalence, and how it can affect breastfeeding. The segment covers the anatomical considerations of tongue-tie, common symptoms, and the variability in diagnosis due to differing assessment tools.

2: Recent AAP Statement on Tongue-Tie

• A review of the American Academy of Pediatrics' recent statement on tongue-tie. The AAP emphasizes a cautious approach to frenotomy, recommending careful evaluation to determine if the condition significantly impacts breastfeeding before considering surgery.

3: Opinions from Other Authorities

• A look at the perspectives from other key organizations, including the Academy of Breastfeeding Medicine (ABM), World Health Organization (WHO), and International Lactation Consultant Association (ILCA). Each body provides different insights into the management of tongue-tie, reflecting the diversity of opinions and approaches in the field.

4: Examination of the Evidence

• A synthesis of current research findings on the effectiveness of frenotomy for breastfeeding challenges associated with tongue-tie. Studies show that frenotomy can improve breastfeeding difficulties and reduce maternal pain in the short term, but long-term benefits remain unclear. Margaret discusses the need for more standardized research and diagnostic criteria.

5: Personal Beliefs and Practical Advice

• Margaret shares her personal perspective on managing tongue-tie in breastfeeding dyads. She stresses the importance of a holistic approach, evaluating both the mother's and infant's anatomy, and considering all aspects of their breastfeeding relationship. Practical advice includes optimizing latch and positioning before considering surgical intervention.

6: Practical Steps for Lactation Consultants

• Tips for lactation consultants on supporting families dealing with tongue-tie:

1. Conduct a thorough assessment using validated tools.
2. Prioritize breastfeeding support strategies, including latch adjustments and positioning techniques.
3. Collaborate with pediatricians and other healthcare providers for a multidisciplinary approach.
4. Educate parents on all available options, including the benefits and risks of frenotomy.

Conclusion:

• Understanding tongue-tie and its impact on breastfeeding requires a balanced and evidence-based approach. By integrating the latest research with practical support strategies, lactation consultants can effectively guide families through their breastfeeding journey, ensuring decisions are made in the best interest of both mother and baby.

Relevant Links:

• American Academy of Pediatrics - Tongue-Tie Overview: AAP
• Academy of Breastfeeding Medicine Protocols: ABM
• World Health Organization - Infant Feeding Guidelines: WHO
• International Lactation Consultant Association: ILCA

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Have questions or want to suggest a topic? Reach out to me at margaretsalty.com or connect with me on social media at Instagram.

Don't forget to share this episode with fellow IBCLCs or students who could benefit from a deeper understanding of tongue-tie and breastfeeding management.

Contact Information:

• Website: margaretsalty.com
• Instagram: instagram.com/margaretsalty

Credits:

• Hosted by: Margaret Salty
• Music by: The Magnifiers, "My Time Traveling Machine"

Hashtags and Keywords:

#IBCLC #LactationConsultant #TongueTie #BreastfeedingSupport #LactationMentor

American Academy of Pediatrics. (2022). Diagnosis and treatment of ankyloglossia in newborns and infants: A review. JAMA Otolaryngology–Head & Neck Surgery, 143(10), 1032-1039.

Berry, J., Griffiths, M., & Westcott, C. (2012). A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breastfeeding Medicine, 7(3), 189-193.

Bruney, T. L., Scime, N. V., Madubueze, A., & Chaput, K. H. (2022). Systematic review of the evidence for resolution of common breastfeeding problems—Ankyloglossia (Tongue Tie). Acta Paediatrica, 111, 940-947.

Francis, D. O., Krishnaswami, S., & McPheeters, M. (2015). Treatment of ankyloglossia and breastfeeding outcomes: A systematic review. Pediatrics, 135(6), e1458-e1466.

Hatami, A., Dreyer, C. W., Meade, M. J., & Kaur, S. (2022). Effectiveness of tongue-tie assessment tools in diagnosing and fulfilling lingual frenectomy criteria: A systematic review. Australian Dental Journal, 67, 212-219.

O’Shea, J. E., Foster, J. P., & O’Donnell, C. P. (2017). Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews, (3), CD011065.