Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 Do you think he would be open to meeting with you? Maybe you can meet w/ him and discuss the newest info on TT and breastfeeding. Emphasize how much help he has been, thank him profusely for helping all the moms and babies. Maybe if he truly knew what a difference he has made by performing this procedure, he will have a better understanding of all the referrals. -See what's new at AOL.com and Make AOL Your Homepage. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 Hi I have 1 doctor who will snip tongue ties in his clinic but every timehe does one he replies to my referral with this letter .Dear Nicola Many thanks for referring X who has had problems with feeding. Shewas found to have a tongue tie. On examination today I do not thinkthis TT is significant but I have divided it anyhow . Im not sure ifthe child will benefit from this but only time will tell. Kind regards....So each time I send in a referral I always send in a report on how theprevious ones are doing ( mostly very well). I know its great that hereplies to me and that he does it ...but Should I send him in some of the more recent studies - or will thatget his back up ? I have sent him in the AAP article as that's what Igive the parents . My impression is that he is just tolerating thisand I warn the parents that he's quite likely to say the tt is insignificant and unlikely to make a difference. But he snips itanyhow . Im trying to come up with a win-win situation here but am aware that Ineed to thread very carefully ! I think he is going to stop doing the divisions in his clinic as he isnow keeping the parents waiting longer ( up to 2 months ) forappointments. All suggestions warmly recieved .Nicola oByrne Dublin. Dear Nicola, My colleague here in SD who catches a lot of TTs and I have had the same situation. The ENTs will schedule the clipping and then try to discourage the clients from having it performed. Here is a sampling of what they have told the clients: Yes, I see a TT, but clipping may not be able to help with this. I am not sure that a clipping will help. It is a TT, but clipping is extremely painful. Are you sure you want to do this to your child? Are you pumping? Well, there you go. Just keep pumping and feed the baby your milk from the bottle. And we have prepared the parents for the fact that breastfeeding is not the only health issue. There could be a problem with speech that might require this procedure when the baby is a little older. We send them to Dr. Palmer's website so that they are familiar with the possibility of GERD and OSA as issues when this baby gets into adulthood. I have a friend of a client who told the client that she lost the breastfeeding b/c she chose not to clip her baby's TT and now as a 6 year old, he has to have the surgery and how much harder it is to prepare a 6 y o for surgery than an infant! We actually have the names and numbers of the surgical assistants for the ENTs, so we fax our reports to the ENTs and f/u w/ a phone call to the Asst. to sched for the earliest appt. that week. They are helpful and we usually have a baby being seen within 48-72 hrs post our appt. depending on weekends, holidays, etc. Finally, we decided we needed to accompany the client to the appointments. When we are in the room, and we hang to the back behind or to the side of the parents w/o saying much of anything, the docs are different, talk differently to the parents. There are some really quite valid reasons for us to accompany them: we are there to provide lactation support/support with latch right after the frenotomy and for moral support for parents who are frequently traumatized by this whole thing. But the real reason is that when we are in the room, the ENTs don't talk to the parents the same way. We had had a problem getting the docs to do the 3s and 4s...even the ENTs who should have been familiar with them, I thought! Then I faxed a copy of the chapter that Dr. Coryllos wrote abt surgical resolution to hidden tongue ties in CWG's new book to one of the PAs that was clipping and had clipped successfully a Type 3 (we have tried all of them in the practice; most do not clip sufficiently, clipping the mucosa, but not the fibrous membranes!). Since I sent that chapter over to the PA, the head ENT has been doing these w/o his former histrionics. Methinks he read the chapter! The chapter goes into more detail than the AAP newsletter abt the steps of the surgery. (A client last spring, May-June, w/ a baby w/ a Type 3, had had a partial clipping. I had confirmed it was partial, scheduled the baby for a f/u appt. for assessment. Two ENTs, including the head of the practice, looked at it and said there was nothing they could clip. The head ENT (arrrrrrrggghhhhh!) told me to go back and pull out my lactation bag of tricks to help this baby breastfeed. As if some trick could compensate for a baby having a TT! I was able to get one of the other ENTs to do it and she clipped it all the way!) I don't know if any of these kinds of things would be things you would feel comfortable doing or if they are even feasible. We have found that we need to help the parents each step along the way. Until this is being taught and taught thoroughly to all pedis and ENTs and LCs, this will be a daunting process for parents to maneuver through. We found we needed to be open to just about anything that would help the parents achieve resolution to this problem. You just never know what will work until you have tried it. Ann See what's new at AOL.com and Make AOL Your Homepage. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 Hi I have 1 doctor who will snip tongue ties in his clinic but every time he does one he replies to my referral with this letter . Dear Nicola Many thanks for referring X who has had problems with feeding. She was found to have a tongue tie. On examination today I do not think this TT is significant but I have divided it anyhow . Im not sure if the child will benefit from this but only time will tell. Kind regards.... So each time I send in a referral I always send in a report on how the previous ones are doing ( mostly very well). I know its great that he replies to me and that he does it ...but Should I send him in some of the more recent studies - or will that get his back up ? I have sent him in the AAP article as that's what I give the parents . My impression is that he is just tolerating this and I warn the parents that he's quite likely to say the tt is insignificant and unlikely to make a difference. But he snips it anyhow . Im trying to come up with a win-win situation here but am aware that I need to thread very carefully ! I think he is going to stop doing the divisions in his clinic as he is now keeping the parents waiting longer ( up to 2 months ) for appointments. All suggestions warmly recieved . Nicola oByrne Dublin. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 Nicola, It sounds like maybe he is doing what we call in the medical field CYA (Cover Your A##). He wants it charted somewhere that he "didn't really think it was necessary, but I'll go along with it" just in case there are complications and the mom comes back to HIM. That's my guess...he wants something in writing absolving himself in case of litigation. I would encourage ALL mothers to report their experiences with nursing AFTER the frenotomy to their pediatrician. Nicola O'Byrne wrote: Hi I have 1 doctor who will snip tongue ties in his clinic but every timehe does one he replies to my referral with this letter .Dear Nicola Many thanks for referring X who has had problems with feeding. Shewas found to have a tongue tie. On examination today I do not thinkthis TT is significant but I have divided it anyhow . Im not sure ifthe child will benefit from this but only time will tell. Kind regards....So each time I send in a referral I always send in a report on how theprevious ones are doing ( mostly very well). I know its great that hereplies to me and that he does it ...but Should I send him in some of the more recent studies - or will thatget his back up ? I have sent him in the AAP article as that's what Igive the parents . My impression is that he is just tolerating thisand I warn the parents that he's quite likely to say the tt is insignificant and unlikely to make a difference. But he snips itanyhow . Im trying to come up with a win-win situation here but am aware that Ineed to thread very carefully ! I think he is going to stop doing the divisions in his clinic as he isnow keeping the parents waiting longer ( up to 2 months ) forappointments. All suggestions warmly recieved .Nicola oByrne Dublin. Wysocki-Emery, RN, IBCLC 2505 Ardmore SE Grand Rapids, MI 49506 www.babybelovedinc.com Be a better sports nut! Let your teams follow you with Yahoo Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
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