Thursday, December 27, 2018


There are still so many ENTs and dentists who perform tongue-tie releases with no preparation, no IBCLC referral and no follow-up in place. When I post on social media about how essential integrative care is, I am told I don't understand the costs involved. When no referral is required, parents are misled into believing the release is a silver bullet. It is not.
The assumption that practitioners ourselves don't understand the difficulty in paying for medical care, is completely false. My family has gone without medical insurance for more years than we've had it, and for the most part, it's been useless anyway, as it covers nothing we need and deductibles are $8-10,000. We all deal with the reality of our profit-driven system, one that ensures only insurance companies come out on top.
That doesn't change what is necessary if our goal is function. I see far too many dyads suffering the consequences of a surgical procedure that can't possibly deliver on expectations, because the release itself cannot resolve issues. The release only allows the bodywork and the lactation support to be effective. No other surgical procedure is performed with such frequency, yet primed to fail due to inadequate preparation and follow-up. 
There are FB groups for families who regret releasing ties. There are many health care providers concerned about babies being released with poor outcomes. This is a legitimate and growing problem that needs to be addressed. 
In my practice I frequently see families who have paid $600-1600 for releases yet their babies still cannot nurse effectively, if at all. Those parents are then forced to pay for my time, often more than they would have if I had seen them in the beginning, in addition to more bodywork than they would have otherwise, and often another release with a different provider, because they saw the wrong release provider the first time...someone who was willing to release without preparation and follow-up.

While it was once very difficult to find skilled IBCLCs, it's become much easier as so many of us work remotely. I see as many as 80% of my clients on-line. Many other IBCLCs now do as well. The trick is to find someone skilled in functional assessment and habilitation, who also collaborates with other providers. That way, you have access by referral to competent bodyworkers as well. Ask questions about their education specific to oral anatomy and function, whether they collaborate and how they prepare for and follow-up after the release. In my practice I teach clients oral exercises that will provide neuro-muscular preparation for babies (this is not simply "suck-training", which many babies don't need at all). Click here for a list of IBCLCs who have taken a three day MasterClass that includes learning these exercises. 
The cost of health care in the US is outrageous. The poor quality of care for the price is even more so. Unfortunately, that doesn't change physiology. The release alone fails over and over again, because the release cannot resolve the full-body issues that stem from the restrictions. The first step, whether or not your baby is nursing, is an IBCLC who can guide you with a functional assessment, coordinate with your other providers and optimize a functional outcome.

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