When Is the Best Time to Act?

Dr. Jasmine Elmore tongue ties

Have you ever been in a situation like this?

You’re having a conversation with someone.

They ask a question.

You give your answer.

But your answer doesn’t make sense to them. So they try to get your answer to shove into a box they’re comfortable/familiar with.

Ever happened to you?

I’m here to let you know this:

Your answer is VALID.

👉We all make sense of information differently.👈

And.👏 That.👏 Is.👏 Ok.👏

Maybe you’ve not felt heard at the doctor’s office.

Maybe you can tell something is going on with your baby, but you can’t put your finger on it.

Maybe that’s not the doctor for you and your baby.

That is ok!

Trust your gut.

(When was the last time a doc said that to you?)

There are plenty of providers out there.

And there IS a doctor who wants to listen to you, validate you, and help you help your baby.

I want to help you make sense of what you see in a way that makes you feel seen and heard.  

Because the bond between healthcare provider and parent is critical to the care that is provided to your baby.  

I’m not here with a preconceived box you need to fit your answer into nicely. I’m here to help.

To share information in a way that makes sense to YOU. And provide a place on the internet that FEELS good to you. 

With that being said, there is a time when your baby SHOULDN’T have his/her tongue released “yet.”  Why?  Because treatment, just like life, is all about timing.  The right treatment at the wrong time is just as dangerous as the wrong treatment all together.  So, with that in mind, let’s list some of the things that take priority before a tongue release.  

But first, I want you to know that when you come into our office for an evaluation, we are looking at all of these things and we will discuss them together.  Every baby doesn’t leave with a tongue tie release completed.  And we love it that way!  Care is personalized to each family, so we have time allocated in the appointment to complete the tongue release the same day or just talk about when is the right time.  No pressure either way.

Now, when is it best to wait?

1 – The pre-work isn’t done yet.

We recommend that all infants + toddlers are seen by a knowledgeable IBCLC or feeding therapist prior to your appointment with us.  I call this the “pre-work” because it lays a foundation of great success for each baby.  Here about AFC, we call these educated professionals “functionalists.”  No, I didn’t create the term — credit here goes to Health Latch Circle.  The functionalist is specifically trained to diagnose issues with proper function, support and retrain correct function with your baby, and have knowledge about how a structural limitation may need to be resolved for the best functional outcomes.  

All too often, I’ve seen infants + toddlers who have their tongue ties released with no pretreatment functional therapy aka “no pre-work.”  More often than not, the tongue tie release is unsuccessful.  Why?   Because it’s the function of the tongue that matters most NOT whether or not it is structurally free.  There is this myth that just because a tongue is released that it knows what to do with its newfound freedom.  Unfortunately, muscles have memory.  So, a restricted tongue needs to unlearn its restricted ways first and continue therapy post-treatment.   Anything short of this process increases the likelihood of long-term failure.

We want to try to get this right the FIRST TIME.  So, I am here to make sure we have the appropriate “pre-work” completed by an amazing functionalist.  As the “proceduralist” (the one who completes the procedure of the tongue tie release) in this journey, it’s my job to prepare you for the surgical process and support you after.  And, make sure you touch base with your functionalist to ensure long-term success.  Our team will assist with making sure I am in touch with the functionalist throughout your baby’s care.  A strong team is the best team.

2 – When feeding issues are complex.

Kayla Fontenot, M.S., CCC-SLP, COM aka @kaylafontenot_slp recently said “it’s possible to do more harm than good to an underprepared sensory system [especially] if there are medical issues that need to be addressed first.”  Thankfully, this is where the functionalist comes into play again.  And a great pediatrician doesn’t hurt, either.  As a part of my evaluation, I’ll check for issues related to my scope of practice.  I won’t EVER try to pretend to know all of the difficulties of babyhood, which is why we advocate for a collaborative approach to care.  But together, we will make the right decision.

3 – When the caregiver is not emotionally ready.

I remember the day I told my mother that I was a 30 year old with a tongue tie and explained all of the symptoms that have come from it.  I will never forget the look on her face.  It’s one of the reasons I decided to pivot my practice and focus specifically on infants + toddlers.  It actually reminded me of a post that I saw recently…

Elizabeth Morel, PT aka @littlemoverspt posted something powerful recently.  Here’s what she said:

“There’s definitely a mourning process you go through when you figure out that your baby has latching issues and residual tension.

Is this my fault?

Am I encouraging these behaviors?

Why is this happening to me?

These feelings are VALID.

But here’s the thing…

After we mourn the fact that our baby isn’t perfect from the start we can jump into action.”

(check out the rest of the post here)

The key takeaway for me as your proceduralist is AFTER WE MOURN we can jump into action. 

Here at AFC, we respect the fact that you may need time to process everything.  We want you + your baby to be ready for a tongue tie release.  And if you’re not, that’s okay.  I will be adding resources to this blog and website weekly, so stay here as long as you need to.  We love having you here.  

The truth is aftercare stretching could be triggering.  And the post-surgical stretches that we will teach you are a critical component to long-term successful outcomes.  I’m just scratching the surface here, but I want you to know that we are here for you.  We will always consider the needs of your entire family.  Baby + primary caregivers are equally important in this process.


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