“As a medical student and resident in pediatrics, I was taught that the tight lingual frenulum was a normal variant of the tongue which caused no clinical impairment of function of the tongue. I was advised to avoid those who said otherwise. This teaching was eventually formalized in both the official education publication of the American Academy of Pediatrics, the Pediatrics Review and Education Program in 1995, and in the testing of the American Board of Pediatrics as listed in their Content Specifications in 1993. Breastfeeding was unusual during the years of my pediatric residency (1975-78) and expertise in the support of the breastfeeding dyad was not in my pediatric training curriculum. I followed the accepted practice until I joined the Academy of Breastfeeding Medicine in 2001 and began my education in support of breastfeeding in earnest.
Things are changing and physicians are rethinking their beliefs in light of the uniform success that is being experienced by those who are releasing tongue-ties. While there are a few remaining holdouts at my center, frenulotomy for breastfeeding difficulty has now been established as an extremely safe and appropriate procedure to perform in the first few days of life. The ever increasing mountain of evidence demonstrating this cannot be ignored much longer by evidence based healthcare providers. As the boulder of opinion about this is nearing the top of the impact hill, more HCPs and lay people alike joint in pushing this boulder over the top. Once this critical mass of opinion has been achieved the process will be self-sustaining and rapidly result in the establishment of a “But we have always clipped problem tongue-ties” standard of practice. This day is not far off thanks to the tireless effort of so many dedicated individuals working to make this happen.
In this book, Dr. Alison Hazelbaker nicely documents the progress of this movement from biblical times to the present explaining in explicit detail the critical milestones of the journey and clearly explaining the anatomic and physiologic processes involved. Her detailed explanations of the origin of tongue in the embryo and clinical difficulties in the infant, child and adult are well constructed and beautifully illustrated. The complexities of both the clinical manifestations of tongue-ties of various types and the politically charged medical environment in which we must operate and convince others of the importance of tongue-tie for breastfeeding, speech, dental, and many other oral functions are discussed in sufficient detail to give the reader a comprehensive understanding of the current issues and the work yet to be done. For professionals who work with breastfeeding dyads the information in this book is essential to a complete understanding of the tongue-tie disorder spectrum. I highly recommend it.”
James G. Murphy, MD, FAAP, FABM, IBCLC