March 26, 2014
Volume 16, Issue 7
Midwifery Today E-News
“Tongue Tie”
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“Out of Many, One: Unity in Midwifery”

Harrisburg conferenceAttend our conference in Harrisburg, Pennsylvania, April 23–27, 2014. Planned teachers include Robbie Davis-Floyd, Carol Gautschi, Gail Hart, Sister MorningStar, Gail Tully, Debra Pascali-Bonaro and Diane Goslin.

Learn more about the Harrisburg conference.

UK conferenceAttend the full-day Spinning Babies Workshop with Gail Tully

Gail will discuss how you can spot a long labor before labor begins and turn it around to a shorter labor. You’ll learn about the 3 Principles of Spinning Babies: Balance, Gravity and Movement in pregnancy and in labor. You’ll compare anterior and posterior fetal position and practice labor progress techniques appropriate to the level of descent.

Learn more about the Bury St. Edmunds, UK, conference.

Quote of the Week

Don’t let the fear of striking out hold you back.

Babe Ruth

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The Art of Midwifery

I don’t think it is ever safe for a parent to revise a tie. Firstly, there are the obvious risks associated with any surgical procedure. Secondly, as many as 90% of tongue ties have a corresponding lip tie, which are highly vascularized and may easily bleed. Thirdly, many ties revised even by pediatricians, ENTs, dentists and midwives (a great percentage actually) are revised incorrectly, meaning not deeply enough. Almost every apparently simple-looking anterior tie has a posterior component. These need to be done by a skilled professional.

Jennifer Tow, founding member of International Association of Tongue Tie Professionals

[This information was taken from a conversation on Jan Tritten’s Facebook profile. Join the conversation on Facebook.]

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Editor’s Corner


I asked on my Facebook profile this question: What two pieces of advice would you give a fledgling midwife or doula to help her on her path?

My answer to this question would contain the following answers: Don’t be envious of other midwives or doulas and their number of clients. There are plenty of births for each caregiver. If your practice is smaller than you want it to be, use this extra time you have to really educate your clients about better birth care. Your number of clients will go up and the world will be a better place by the number of babies born optimally. The world will also be better because you will be fostering a sense of unity.

Cynthia Luxford gave this answer: Slow down! Don’t be lured by fast-track training sites. Snuggle in with a mentor and ride along under her wing as you make this journey. The patience you will learn on this slower path will serve you well as you begin caring for moms and babies. It is worth the extra time—just like cooking! Slow-cooked food, with attention to all the right and [healthful] ingredients, produces a meal that nourishes those who partake of it. Fast-cooked foods will fill you up, but are missing some key elements that are necessary for health and longevity.

Here is another answer from Savita Jones: The path to becoming a midwife is similar to the stages of pregnancy, labor, delivery and postpartum. In the beginning, we are flooded with hormones, faced with choices and filled with excitement for what’s to come. Then we grow and start to show. We can feel this new life take hold. In awe of the process, we stretch to the max, face some challenges and get a bit uncomfortable as we become eager to be done. Then we wait for the natural timing to start the labor. It comes and the rushes are rewarding but intense. We surrender, we feel many emotions, we let go and we trust because we have stayed healthy. We call on our support people and find the strength to finish. The process is different for everyone. Remember to use your heart, hands and mind equally. Remember to learn from many different sources and individuals.

— Jan Tritten, mother of Midwifery Today

[This information was taken from a conversation on Jan Tritten’s Facebook profile. Join the conversation on Facebook.]

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

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Conference Chatter

We look forward to welcoming you to the Harrisburg conference in April!

This will be a time you set aside to improve your practices by learning, loving and networking. We hope you will take advantage of all of the amazing teachers and registrants who will be there with you. Use your time wisely by making new like-minded friends as you go to the great classes you have chosen.

We are so sorry Ina May and Stephen Gaskin will not be able to join us this year. Angelina Martinez Miranda, a very gracious and excellent teacher, has agreed to teach in their stead. Angela’s unique knowledge and techniques will be very important for your practice. She is a gift to all of us.

It is by having a sense of unity with others doing similar work that we can move toward better birth practices.

— Jan Tritten

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Harrisburg PA conference, April 2014
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Featured Article

The Role of the Shy Hormone in Breastfeeding

There is no breastfeeding without oxytocin, since the milk ejection reflex is dependent on the release of this hormone. The mechanical effects of oxytocin have been well known for a long time, not only for inducing contractions of specialized breast cells during the milk ejection reflex, but also for inducing uterine contractions during childbirth and orgasm, and for inducing contractions of the prostate and seminal vesicles in the sperm ejection reflex. The behavioral effects of oxytocin are also well understood; it is commonplace today to summarize these effects by using the term “love hormone.”

We have still a lot to learn about oxytocin release. However, we have a sufficient amount of physiological and observational data to conclude that the release of oxytocin is highly dependent on environmental factors. The best way to summarize what we already know is to claim that oxytocin is the “shy hormone”: it behaves like a shy person who does not appear among strangers or observers.

This is the kind of knowledge that is not easily digested where breastfeeding is concerned. I have heard many stories of mothers who required guidance to overcome breastfeeding difficulties. The advice they received almost always focused on the position of the baby when latching on. Common recommendations would be different if it were better understood that many difficulties in breastfeeding are related to the release of the shy hormone. Instead of being guided to find the right postures, the mother might be first advised to stay with only her baby in a small dark room with the door closed and the guarantee that nobody will enter. It is well demonstrated that the shy hormone does not appear in situations associated with a release of adrenaline. This implies that the room must be warm enough to make comfortable skin-to-skin contact between mother and baby possible. I know from experience that such simple suggestions can help break a vicious circle during a critical phase of lactation.

Michel Odent
Excerpted from “The Role of the Shy Hormone in Breastfeeding,” in Breastfeeding, a Midwifery Today e-book
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  • The Turquoise Revolution—by Diana Paul

    Diana Paul shares about the birth revolution movement that was begun at a recent Midwifery Today conference.

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Birth Q&A

Q: Have you dealt with a baby that was tongue tied? How did you know and what was done about it?

— Midwifery Today

A: I’m seeing more and more tongue and lip ties. I refer people to a doctor in Portland that uses a laser to treat these issues—no bleeding. A mom’s ninth baby had a severe posterior tongue tie; it was so bad that the baby could hardly open her mouth. I couldn’t get her to suck on my finger even. She had a revision done, but still could not suck. The baby needed oral stimulation and exercise. Mom pumped for one year and finger fed or syringe fed her baby until she was eight months old and finally able to use a bottle. She continued to pump until baby was one year old. What dedication—she blew my mind!

— Mary Bernabe

A: My son had a lip tie and a tongue tie. The first few days of breastfeeding were horribly painful and I knew something was not right. He could not flange his top lip out when latching. He took forever to finish eating and he was extremely gassy. I looked at his lip and could tell right away that there was a tie, but I wasn’t sure about the tongue tie. He was born at home so I didn’t have the ability to check with a pediatrician right away. When I took him in for his first visit, he was three days old. The nurse practitioner confirmed his lip tie and said she was unsure about the tongue. He was not gaining weight properly, so it was a huge concern. I was able to ask around and got the name of a dentist about an hour away who had experience with tongue ties. I contacted him and he was able to get us in very quickly. At 10 days old we took my son in and had his lip tie and tongue tie cut with a laser (the dentist confirmed he had a posterior tongue tie). My son started gaining weight and nursing better within days.

— Kate Lynch

A: I was just speaking about this today with a very active midwife. She told me that in her first hundred babies (years ago), she only saw about two ties. Now, in the last hundred babies she has seen only about two with no tie! I believe strongly that this is due to our environment; tongue tie is an early effect of environmental damage.

— Barbara Covington

A: Tongue tie is one of my areas of greatest interest and specialization. I began looking at the synthetic folate connection in 2006 and since have explored it in much more depth, working with Ben Lynch to investigate epigenetic factors that might be involved. I am in New Zealand right now lecturing on epigenetics and gut health and have been speaking with another of the founders of IATP (International Association of Tongue Tie Professionals) about incidence and have asked him to look at his statistics in a different way to see if we might find the increase represented in those statistics that we see clinically. Of interest, though is the fact that posterior tongue tie incidence is almost equal between males and females (more likely epigenetic) while anterior tongue tie incidence is 2:1 among boys (so more clearly genetic). I have also explored the impact of methylation on development of the midline and airway development and have been slowly connecting the dots on the various factors. I have webinars recorded and available on clinical evaluations and treatment including bodywork and aftercare and on the epigenetic, gut, airway and postural outcomes of tongue tie and oral development. I encourage folks to follow the IATP page on Facebook, as we are gearing up for our next conference in Montreal and are about to go live with our website.

— Jennifer Tow

A: I got to where I checked every baby at birth. A bad tongue tie caused problems with latching. My own youngest wasn’t identified as having a tongue tie until he was three. We had trouble with nursing, he didn’t talk early (we attributed it to his older sibling doing all the talking for him) and when he finally talked, he had a slight lisp. My back-up doctor took one look at him, told him to touch his nose with his tongue and snipped it free!

— Diane Barnes

A: If I meet someone who has breast soreness, whose baby is slow to gain or has issues, or even if the mom suspects there is a tongue tie, I advise revision and suggest massage. Oral ties that impede nourishment are not a variation of normal—they are a condition that causes nutritional deficit and they require correction. A baby who isn’t getting enough food needs help.

— Natalie Ovanin

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My first baby had an undiagnosed tongue tie. I had asked several health care providers, but no one knew how to tell if it was a tongue tie. This led to eight weeks of bleeding nipples. Eventually I healed, but breastfeeding was always painful for my baby. He had digestive issues and sleep issues. My second baby was not tied, but my third was, and this time I found a tongue tie support group on Facebook and was referred to a local dentist. My breasts were always full and I was getting mastitis. My baby’s latch was painful and I could hear her sucking air. She had a lip tie that wrapped around to the pallet and was very thick and tight, and a posterior tongue tie that prevented the back of her tongue from lifting during nursing/swallowing. She went from 9 lb to 7 lb by the time we got in to have it corrected by laser. It appeared painless and I was right there with her. She slept through the exam and photos, and she finally woke up when they put a tongue lifter in her mouth. The laser procedure took about 45 seconds and then I nursed her right away, and she drifted back to sleep in my arms. Her latch was light and fluttery—not painful. She rapidly gained back her lost weight.

— Christina Chaston Monteith

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