Hi, welcome back. This is Lisa Paladino, and I'm so glad you've joined me for this episode today. We're going to talk about the team approach to tongue tie. Why it's often not "just a little snip" as we often hear, But first let me it tell you about a Professional's guide to Tongue Tie in the Breastfeeding infant, my course for professionals and why it's important to learn about tongue tie, even if you aren't a lactation consultant. whether you are a lactation consultant, an RN, an NP, a doula, a midwife MD, a do an SLP, a DC, a PT, an OT, a DDS, et cetera. A professional professional guide to tongue tie in the breastfeeding infant is for you. If you serve pregnant or breastfeeding families in any capacity, and you are curious about tongue tie it's for you. If you want to feel confident to counsel guide or treat infants with tongue tie, depending on your role. In the course, you will learn the facts and protocols that clear up the confusion and misinformation that you have heard, and you will become a trusted resource for breastfeeding families that have no one else to turn to. Actually families need you.
I didn't learn this in school. Did you? Tongues tie treatment can be complex. And those who expect relief of symptoms with a quick snip or a laser release, even by an experienced provider are usually disappointed the teamwork model of care, which I will discuss in detail in this episode, knowing why and which providers are necessary, will make things easier for you and provide effective outcomes for your patients and clients. The truth is that parents are failing to meet their feeding goals. Parents and babies are suffering all over social media. I see pictures of parents posting their child's mouth and asking, is this a tie? They can't find anyone in person to help them. And many don't know to go to a lactation consultant every day. No exaggeration. I hear from families who have been told by pediatricians and other healthcare providers that their baby has no tie or a slight tie.
Perhaps you have said this to families as well. That's okay. I used to say this too. It's my mission to make sure that families will get the support they need to reach their feeding goals. So stay tuned for more info later in this episode, or check the show notes below for an important announcement about a flash sale going on February 1-3, 2022. If you're listening this week in this. In this episode, we will chat about the team approach to tongue tie. And in future episodes, you'll hear stories of families who went directly to the provider for procedure of release of the restriction and how things didn't exactly improve that way. Now I know that what I will describe here is an ideal approach. One that may not be available to all families and all providers, but I believe that it's important to have a standard of care to reach for and to make adjustments when necessary.
If you are a parent who had a baby with tongue or lip tie, and you didn't have the awareness or the opportunity to have a team approach, please don't feel badly about it. One of my favorite sayings is by Maya Angelou, "Do the best you can until you know, better then when you know, better do better". Please know that I am not preaching here because I did everything right. Actually I've learned through the mistakes that I've made with my own kids. And in failing to understand about tongue ties in the early days of my practice.
Now I say that I preach the tats team approach T O T S is an abbreviation, meaning tethered oral tissues. This includes lip, tongue ties and other restrictions in the mouth. In a previous episode, I spoke all about tongue tie and the definitions. You can learn more if you don't understand what it is, but I'm not gonna go into it today. So in my practice, we use a team approach to individualized care based on the baby's function and how eating is going for both parents and babies, infant and parents require different therapies, all are interconnected and depend on each other for success.
First, I'll explain the different members of the team. Then I'll describe how this team approach typically looks, at least in my practice. In a breastfeeding infant, the IBLCLC is generally considered the team leader who best understands what other therapies the infant needs and is aware of other professionals to refer to for those who don't know what an IBLCLC is. It's an International Board Certified Lactation Consultant. This is the highest level of lactation certification that is available. There are lactation consultants with many initials and they all have a place on the team. There are CLCs CBSs etc,, but only the IBLCLC is trained in exams inside the mouth and assessment of complex lactation issues. If you are with a lactation consultant who isn't helping you find solutions to your concerns, make sure she is an IBCLC. I often get asked. What's so different about an IBLCLC. So I'll give you an example, a CLC or so certified lactation counselor takes a five day course and a short exam. While this is an amazing course, and it's how I started my lactation career. It's minimal preparation and knowledge compared to the many years college courses, lactation classes, thousands of hours of preceptored training and curriculum required to become an IBLCLC.
Actually I hold three professional certifications. I'm a registered nurse certified nurse midwife and and IBLCLC, maintaining my IBLCLC Certification is the most challenging of all three. The recertification process is so rigorous that we must retest every 10 years and pass again with many hours of study and additional education credits required to qualify, to take the test. I just took my recert exam and passed in September, such a relief. In most cases, the IBLCLC is the best expert to evaluate parent and infant feeding and determine if tongue tie is the cause of the breastfeeding concerns, or if there's another reason for the feeding difficulty. Other reasons can be low milk supply, scheduling of babies, the way the parent holds the infant, little bumps along the road of the birth. So many things can cause breastfeeding difficulties. And we don't want to just think about the tongue tie. We want to make sure that there's nothing else going on first.
I just spent lots of time describing just one member of the team, but I thought it was important for everyone to have that baseline knowledge. Other members of the team are a group I refer to as body workers. The definition of body work is any technique involving touch massage manipulation and or energetic principles for the improvement or restoration of health. Sounds like something we all deserve and need. Right? I love having regular chiropractic adjustments and massages and CST has been useful at certain times in my life. And many parents that I meet may have some experience with some of these modalities for themselves. But when I mention it for babies, I often get some strange looks. So let's talk about babies' bodies. Many babies are born with tightness in their muscles or fascia that prevent comfortable and functional movement. Birth can be hard on their little bodies.
Sometimes there are asymmetries. One side is pulling more than the other or their newborn heads can have molding or MIS shaping that is uneven or even flat in the back. What I see in my practice is that we can't always be sure if the tongue is actually restricted, or if it's the muscle of the head and neck, pulling it back or making it hard to tilt the head in a way that's always comfortable and efficient for nursing body work such as chiropractic, osteopathy, cranial sacral therapy (CST), occupational therapy, physical therapy, massage, et cetera, can help the small body relax and open up evenly and fully going to be completely honest about the next member of the team.
It took me a long time to realize that an SLP speech, language pathologist, feeding therapist belonged on my team. Now this modality is indispensable to my practice. I often refer to them for infants who have an oral problem that I can't solve with my lactation skills. For example, an infant who won't take a bottle can't feed efficiently on breast or bottle, or has other issues of tone in the face or mouth. If you are an SLP, you play an important role in assessing for oral restrictions because you may be the only provider that sees this child or baby and is looking. So I love my SLP for, and I regard them highly on my team.
The next member of the team is the medical provider for procedure or surgery. Often. This is the only referral one gets when tongue ties is suspected, right? The procedure to release the frenum or the tie is called a frenotomy or frenectomy. This surgical procedure can be done by a doctor, dentist, midwife, NP, etc, preferably a provider who is comfortable and experienced with laser release. I'll do a whole episode on frenotomy, but for now I'll just say that my favorite tool is a CO2 laser. However, there are doctors who are skilled with scissors to release the restrictions as well. Please seek out an expert for frenotomy, usually a pediatric dentist who has specialized training. You do not want this done by someone who has to be convinced that the baby has a tongue tie. You want an expert, so this is done completely and correctly and safely.
Now let's talk about how this typically works in my practice. In the ideal world, the tongue tie would be discovered or suspected by the midwife or OB or pediatrician who refers to the IBCLC, but honestly, most parents that I see in my office, either suspect tongue tie themselves, or come to me for other breastfeeding concerns and have never heard of tongue tie. When they come, I make an assessment and plan of care for the parents, the infant, and how we're going to handle feeding. Depending on the case, the infant can and be evaluated by a body worker before considering frenotomy. But in other cases, the frenotomy is more of an emergency, but that's not typical. Usually the body worker or SLP, depending on the individual situation and myself will collaborate to determine need and readiness for frenotomy. And after the procedure, the family continues to see myself, the IBCLC, and the body worker, or the SLP until symptoms are resolved.
So now that I've explained the teamwork model of tongue tie treatment, what do you think? Did it clear up any misconceptions? Were there any aha moments for you? You are so welcome to text me your thoughts. 917-725-1791. Yes. Text me. I'd love to hear from you. You'll hear me say this all the time. I didn't learn this in school. Did you? Tongue tie treatment can be complex. And those who expect relief of symptoms with a quick snip or laser release, even by an experienced provider are usually disappointed. If you're looking for a course now with four L-Cerps for lactation consultants, join us for a flash sale of Professional's guide to Tongue Tie in the Breastfeeding Infant, happening this week, February 1-3, 2022 Use coupon code SAVE20PERCENT.
It's only available February 1-3, and only for listeners of this podcast. The link to the program: https://bit.ly/TTProCourse.
The truth is parents are failing to meet their feeding goals. Parents and babies are suffering due to misdiagnosis of oral restrictions.
Join my mission to make sure that families will get the support they need to reach their feeding goals. Again use the coupon codes to save 20% while you are in the show notes, please, if you like this podcast, follow us, share, review, and keep coming back. I'll be here every week with a new episode. Next week, we're starting with our interview shows. I can't wait. Thanks so much for joining me today on the Tongue Tie Experts podcast.