Podcasts · Spill the Milk Breastfeeding Podcast

💦 Who Told You Your Baby Needs a Revision?

· 37 min · S2 E3

Episode 💦 Who Told You Your Baby Needs a Revision?

0:00 37:29

Okay, friends… I’m a little spicy in this one. Actually, I’m pretty pissed. 🔥

Tongue-tie revisions have become one of those breastfeeding conversations where I keep asking myself:

How did we get here?

I’ve been helping breastfeeding families for more than 20 years, and I remember practicing before it seemed like every breastfeeding problem led to somebody looking inside a baby’s mouth for a tie.

Now a mom can post online:

“My nipples hurt.”

And within minutes:

“Have you had your baby checked for a tongue-tie?”

WHAT?!

Nipple pain tells me we need to assess the feeding. It does NOT automatically tell me something in your baby’s mouth needs to be cut.

In this episode, we’re talking about the rise in tongue-tie diagnoses and revisions, internet advice, babies being revised before leaving the hospital, repeat procedures, informed consent, potential complications—and something we don’t discuss enough:

The baby.

How many people need to put their fingers in this baby’s mouth? And because a baby can’t tell us, “Enough,” shouldn’t that make us MORE thoughtful about what we’re doing to their body?

I’m also sharing two cases from my own practice that have stayed with me.

This episode is NOT anti-frenotomy. Some babies with symptomatic tongue-tie may benefit from one.

What I’m against is jumping from:

“Breastfeeding isn’t working” → “Your baby needs a revision.”

Before we cut anything, I want to know:

💦 Has someone watched an ENTIRE feeding? 💦 Has Mom been taught how to improve the latch? 💦 Is baby transferring milk and gaining appropriately? 💦 What is diaper output telling us? 💦 What is Mom’s milk production doing? 💦 What other causes have been considered? 💦 What FUNCTION is the frenulum interfering with? 💦 What are the benefits AND risks? 💦 What happens if we wait—or if the procedure doesn’t work?

A visible frenulum is not automatically a feeding problem.

Finding a frenulum is not the same thing as finding the cause of the feeding problem.

I’m not anti-procedure.

I’m pro-assessment, pro-informed consent, and pro-baby.

Before we cut anything, ask:

What problem are we actually trying to solve?

📖 BEFORE YOU REVISE

If a tongue-tie or lip-tie procedure has been recommended for your baby, I created Before You Revise: The Parent’s Checklist Before Saying Yes to a Tongue-Tie or Lip-Tie Procedure to help you understand what should be assessed, what questions to ask, the potential benefits and risks, and when it may be time to slow down and get more information.

📖 Get Before You Revise: https://www.amazon.com/dp/B0HKDJNK95

🤍 WANT MORE SPILL THE MILK?

Come hang out with me on Patreon for early access, bonus conversations, Q&As, resources, behind-the-scenes content, and our community.

The podcast is where I share the education. Patreon is where we get to hang out a little more. 🤍

💦 Patreon: https://www.patreon.com/BabyWhisperer?utm_campaign=creatorshare_fan

🌐 https://babywhisperernicki.com

📚 RESOURCES & FURTHER READING

American Academy of Pediatrics — 2024 Clinical Report https://publications.aap.org/pediatrics/article/154/2/e2024067605/198022/Identification-and-Management-of-Ankyloglossia-and

Academy of Breastfeeding Medicine — Position Statement https://www.bfmed.org/assets/Anklyloglossia%20position%20statement%202021.pdf

American Academy of Pediatric Dentistry — Frenulum Policy https://www.aapd.org/research/oral-health-policies--recommendations/managment-of-the-frenulum-in-pediatric-dental-patients/

JAMA Otolaryngology — Feeding Evaluation & Frenotomy Rates https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2737712

The New York Times — Inside the Booming Business of Cutting Babies’ Tongues https://www.nytimes.com/2023/12/18/health/tongue-tie-release-breastfeeding.html

My goal isn’t to convince you to breastfeed. That’s your decision. My goal is to support your decisions with education and compassion.

Nicki Davis, RN, BSN, IBCLC Baby Whisperer Nicki Helping Families Feed with Confidence.

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