I’ve been writing about tongue ties and lip ties for a couple of years, and have been involved in some grassroots efforts to expand awareness and access to providers. Things had been going at a slow, yet calm pace until….until the skeptics and adversaries started speaking up. The first time this really hit our radar, I think, was this blog post from Nancy Mohrbacher. Now, I have a lot of respect for Ms. Mohrbacher, but I think there are a few things that were misleading in her portrayal of the issues. Reaction to her post was swift and divisive. Interestingly enough, comments on her post were removed and the ability to comment was turned off. Other posts have surfaced, but it was this post that prompted me to clarify a few things.
Myth #1: ______ are diagnosing tongue ties and lip ties
From Nancy Mohrbacher’s post:
I appreciate the growing awareness of tongue- and lip-tie issues and health providers willing to do interventions. Yet often the diagnosis is coming from friends, Dr. Google, and Facebook discussions.
OK, so major point of clarification: Medical Doctors can diagnose. Chiropractors (in some states) can diagnose. Advance Practice Nurses can diagnose. Physician Assistants can diagnose. Dentists can diagnose. Unless they hold any of these other licenses, guess who can’t diagnose?
IBCLCs (unless they are also MDs, DOs, etc.) can not diagnose. The internet isn’t diagnosing. Friends aren’t diagnosing. Facebook groups aren’t diagnosing. Once a parent is referred by whatever source to a provider who can do frenectomies, that provider then can diagnose and treat. Period. So let’s stop saying otherwise, OK? Thanks.
Myth #2: Moms aren’t getting help from IBCLCs before wondering if tongue ties or lip ties are an issue
In the 2nd blog post I referenced above, “Revise the Ties, Keep the LC,” she lays out 7 reasons why IBCLCs need to be involved with sorting out breastfeeding issues. I don’t think anyone disagrees with this at face value. But what isn’t really addressed is, if you read many accounts written by moms who have ended up getting frenectomies done on their little ones, most of the time at least one IBCLC, if not 3 or 4, have been involved with working with a mom. And while the author gives the advice that,
Every lactation consultant is an expert on breastfeeding, but not every lactation consultant is an expert on tethered oral tissues, structural issues as they affect breastfeeding, and recovery after frenectomy. Many of us have invested considerable amounts of time and money to acquire knowledge and information that is more advanced than the basic training required by the International Board of Lactation Consultant Examiners (the certifying board for IBCLC’s). If you are not sure whether the lactation consultant you have contacted is an expert in this area, just ask. Ask if they are knowledgeable on complete tongue function, if they have a good working relationship with local providers that release tongue/lip ties.
I can say, in my year and a half of advocacy work, this is hard for me, someone not even in crisis mode with a tiny, hungry baby, to figure out. How on earth are new moms supposed to suss all of this out? They get told that an IBCLC is the person to see for help with breastfeeding, and when they don’t get that help from the IBCLC that actually helps….I don’t know what to say to them.
Myth #3: This issue only affects breastfeeding
There are lots of studies that exist that show links to tongue ties and lip ties and things like sleep apnea, TMJ, speech issues, torticollis, overbites, crowded teeth, etc. (And of course, as I type this, PubMed isn’t working.) You can find lots and lots of info on these various issues over on Dr. Ghareti, ENT’s blog, including a link to the video interview I did with him a year ago. Since teeth, speech, etc are so easily affected, that’s often why dentists are more likely to be receptive to diagnosing and treating lip ties and tongue ties than other providers.
I do realize this is an evolving issue, but it’s easier to have a conversation as professionals if you at least keep the three points I made in mind. It’s easily to vilify, oversimplify, and misrepresent the issue, but that’s not fair to anyone. We’ll all do much better if the dialogue is respectful, open, and there’s no more name calling.