The American Academy of Pediatrics (AAP) recently released new guidelines on the management of tongue-tie (ankyloglossia) in infants. Tongue-tie occurs when the tissue (frenulum) that connects the tongue to the bottom of the mouth is too tight or short, restricting movement. This condition can negatively affect breastfeeding, making it difficult for babies to latch and transfer milk efficiently.

However, the AAP’s new guidelines have raised concerns within the breastfeeding community, particularly among lactation consultants and healthcare professionals like Dr. Bobby Ghaheri, and Dr. Jack Newman, experts in tongue-tie and breastfeeding. These guidelines emphasize a more conservative approach, recommending that healthcare providers delay surgical interventions like frenotomies (tongue-tie release) in many cases, suggesting that tongue-ties may not always interfere with breastfeeding.

The AAP’s new recommendations suggest that many babies with tongue-ties may be able to breastfeed without surgical intervention, which could downplay the significant challenges many mothers face. Lactation consultants and physicians, including Dr. Bobby Ghaheri, have voiced their concerns that this approach overlooks the real struggles of breastfeeding moms who encounter tongue-tie issues. Tongue-tie can cause pain during nursing, poor milk transfer, and lead to premature weaning if not addressed in a timely manner.

Dr. Bobby Ghaheri, a well-known advocate for breastfeeding and infant oral health, believes the new guidelines are not helpful to mothers or lactation consultants. He argues that tongue-tie can severely hinder breastfeeding success, and delaying treatment, as recommended by the AAP, may lead to ongoing feeding difficulties. According to Dr. Ghaheri, early diagnosis and intervention can significantly improve breastfeeding outcomes, preventing the physical and emotional toll that comes from extended breastfeeding struggles.

How This Affects Breastfeeding Moms

For many mothers, tongue-tie can be a source of extreme frustration and pain. Babies with tongue-tie may struggle to latch properly, which leads to sore nipples, inadequate milk intake, and slower weight gain. Mothers may experience an oversupply or undersupply of milk, further complicating the breastfeeding journey.

The AAP’s recommendation to delay intervention might leave mothers feeling unheard, especially those who know something is wrong but are advised to “wait it out.” This can lead to more stress, guilt, and even early cessation of breastfeeding—something lactation consultants strive to prevent.

While the AAP’s new guidelines aim to reduce unnecessary surgical procedures, experts like Dr. Ghaheri argue that they overlook the significant challenges tongue-tie can pose for breastfeeding moms. Timely intervention and support from knowledgeable lactation consultants are crucial to ensure that mothers can successfully breastfeed without unnecessary pain or frustration. If you suspect your baby may have a tongue-tie, it’s important to seek out a second opinion from a specialist who is well-versed in both breastfeeding and tongue-tie management.

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