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It is unfortunate that a member of the American Academy of Pediatrics Section on Breastfeeding was not also consulted for this article. The ENT world is struggling to catch up with the tide here. Families are often better educated on optimal breastfeeding practice than are some of the practitioners they rely on, and ankyloglossia is a big deal to a mother who wants the best for her child. Some mothers have even been told, having had treatment refused because the provider doesn't agree there's a problem, that "no one will think badly of you if you stop breastfeeding because of the pain". It shouldn't hurt a mother who has good technique, to feed her baby. At all. Circumcision is FAR more interventive, yet is given almost no serious concern. Posterior ties are the least likely to be identified, are perhaps the most likely to cause difficulties, and are not "rare" in the breastfeeding difficulty world. They are hard to see, and must be evaluated functionally, both on and off the breast, and by feeling in and out of the baby's mouth. According to both the US Surgeon General and the CDC, relatively few physicians have the training to knowledgably assess a feed at breast (most MDs have never had ANY formal breastfeeding education, and thank goodness for those who took it on themselves, such as the members of the Academy of Breastfeeding Medicine). If the baby cannot extend his tongue to his lower lip AND elevate his tongue nearly to his palate, BOTH WITH HIS MOUTH WIDE OPEN AS IS NEEDED AT BREAST, the baby is unlikely to be able to breastfeed effectively. This puts both the baby and the mother at risk of premature weaning, which puts them both at increased risk of everything from diabetes to breast cancer. There is terminology, diagnostic, and treatment confusion, due mostly to the rapid increase in breastfeeding rates and research and the slow rate of implementing change of practice, but there is very poor funding for breastfeeding support. There likely ARE opportunists looking to make money on this issue, but it's surely NOT the International Board-Certified Lactation Consultant (IBCLC) who identifies the problem, and struggles alongside the moms to get treatment. These families want to be heard, to have their concerns taken seriously, and to get help, not platitudes.
Kay McKee, IBCLC, RLC, BA (26 yrs and 12,000 babies)
It is unfortunate that a member of the American Academy of Pediatrics Section on Breastfeeding…
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