The Triad for The Dyad

Triad for the Dyad final.png

I find it very important to focus on a comprehensive approach when it comes to treating ties. A few years back I heard Dr. Bobby Ghaheri speak about ties. He said something that was really eye opening to me and it was this…”Breast-feeding is a fundamental part of an infant’s life. If something is wrong with this instinctive behavior, then the baby must compensate in a way that forces them to biologically change.” This statement summarizes the complex nature when it comes to ties.

In most cases it truly takes a dedicated team of hardworking professionals to get the baby back on track. In the depiction above, I break it down into 3 main categories: The lactation team, the surgical team, and the bodywork team.

I put the lactation component at the top because this is where it all starts. The International Board Certified Lactation Consultant (IBCLC) has the highest level of training when it comes to breastfeeding care. I look at the IBCLC as the quarterback in determining what needs to be done when breastfeeding is problematic. They truly are the breast (and bottle) feeding experts and should be the first point of contact when breastfeeding problems ensue.

The surgeon component consists of many different professionals, as noted in the diagram. Is there any type of provider in the list that has superiority among the rest? I talked to a close colleague who did a 2 year pediatric dental residency after we graduated. When asked how many tongue tied babies he treated during his residency his answer was zero. I talked to another colleague who is an oral surgeon and asked the same question. How many tongue tie cases did you treat during your 4 year residency? About 10. How many on babies? Zero. As you can see, treating tongue and lip tied infants is not vastly taught. Instead, it requires a passion and desire to help distressed mothers who are having trouble feeding their infant AND a thirst for knowledge that was never taught. This applies to IBCLCs as well.

The third component, the bodywork and therapy, is a very general category of professionals that help with the compensations as a result of ties. Every baby that has feeding symptoms is a candidate for body work. Some babies require a lot of therapy and some may not need as much. I have seen babies improve even more after surgical release when bodywork was done before and after. Babies just seem much more relaxed and balanced after bodywork therapy.

The main point is that when we are dealing with tongue or lip tied babies, one aspect of the team cannot function alone. I am constantly consulting with IBCLCs, SLPs, PTs etc when it comes to the care of an infant. I find the most success when all 3 points of the triad are in sync and streamlined harmoniously. Unfortunately, the system as whole is not set up this way. We may not be there yet, but we’re closer than we were yesterday. If there is no struggle, then there is no progress.