Birth, Baby!

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Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a birth doula, hypnobirthing educator, and pediatric sleep consultant.

Samantha is a birth doula, childbirth educator, and lactation counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum journey.

All right, I told you guys that we were gonna have multiple episodes with Naiomi Catron because we just love her.

And she is here today to talk to us about lip ties, tongue ties, and how it relates to feeding.

So thank you so much for being back with us.

Thank you for having me, I appreciate it.

Thanks for not tired of hearing my mouth.

Never, never.

So to start us off, tell us what the heck is a tie?

What does that even mean?

That is a million dollar question.

There is not one definition.

So that's the first problem with this whole world of tongue ties is that there's not an agreed upon definition of a tongue tie.

So what your pediatrician might view as a tongue tie versus your lactation consultant versus whoever else is in there looking at your baby's mouth is super subjective.

And so what you should know, generally speaking, the accepted description of a tie, I think I have it written here somewhere, but it is a piece of tissue with connects to the upper lip or the gum that's for the lip or a piece of tissue that attaches from the floor of the mouth to the bottom of the tongue.

And so that is called a frenulum.

That's the proper name for that thin stringy thing.

Like people who are watching on YouTube can look in my mouth and you can see I have a thin, everyone basically mostly has a thin stringy thing under their tongue.

Now, now we're all doing it.

Cause now I wanna know, can I see as much as I can see yours?

Mine is very pronounced.

Yours is not as pronounced.

Mine needs to get, I need to get a release here.

I can see yours.

Everyone has to watch this one on YouTube.

Oh my gosh, Sam, we need to see you up in our office.

I'm a little concerned about you.

Oh, okay.

Anyway, we'll talk about this later.

So that's how I first found out.

I had a tie as I went to a course and I was like, I don't have a tie, use me as a model.

And then the myofunctional therapist was like, just kidding, so okay.

So the first thing is there's a piece of tissue under the tongue.

That is normal.

The tie part.

So the real medical term for tie is called ankyloglossia.

I can't spell it, but it sounds like a dinosaur, right?

That is the medical term.

A tie, really, what it really means is that that piece of tissue under the tongue or lip is causing a restricted range of motion, aka a functional deficit.

So you ask, what does functional mean?

Well, a tongue should do stuff.

So what should it do?

It should do lots of things, but depending what you as the parent find to be the most important thing, that's when it becomes a restriction.

So for example, I work with a dentist that y'all will interview soon, and he's had a patient who came in with one of those tongue ties that's all the way to the tip, that's like on a textbook, that you cannot miss it unless you're blind.

He had no problems except for kissing a girl.

So then it became a functional deficit because he couldn't kiss a girl.

I have to tell you, my ex-husband had a severe tongue tie, and he never knew until he went to get his tonsils out.

Then when he got his tonsils out or when he got the assessment or whatever, they were like, you have a really severe tongue tie.

And he goes, I do?

And he always used to joke because he would stumble over his words.

He would go, stop, don't make fun of me, I just have a fat tongue.

He always said, I just have a fat tongue.

And he got it released.

He actually hated that, I think, more than the tonsils getting out.

But it really wasn't that bad.

He was just a baby about it.

But it was that he was able to speak better afterward.

He had lived 28 years with a tie and just saying, I have a fat tongue and I stumble over my words.

And it was like a thing that made himself conscious.

And then it was just like an afterthought to do with this procedure.

And it made a big difference.

You just learn how to compensate.

Your body compensates.

And so that's the whole deal is like, as I was like, at least in my practice, we're all about, we don't want our babies compensating.

We want them to soar.

And whatever they're doing, we want them to be competent as opposed to like compensating.

So we want competent feeding, not compensatory feeding.

But I'm going to tell you, I have seen so many babies with ties that can breastfeed just fine.

So that's why these definitions can be very nuanced.

But getting back to like what really is a tongue tie.

And I say there's a functional deficit.

What we look for on the feeding side of things is we want the baby to be able to lateralize your tongue.

So their tongue should move like a snake tongue side to side.

It should not airplane.

When I say airplane, it should not look like the tongue is like trying to move to the side, but you only like get a little kind of like teetering left to right.

We want like a full whipping that tongue back and forth, side to side.

And then most importantly for breastfeeding is to get the back of the tongue.

I don't have a tongue model here.

The back part of the tongue seal to the roof of the mouth.

So when your baby's sleeping, you should be able to press right underneath their chin behind in that soft spot and get it to stick up.

And then you pull their chin down.

And you should see it stuck and sealed up there.

And that's just one little test.

We do other lots of other ways to assess the post.

We call that posterior tongue lift.

But let me tell you this.

If you're at the hospital and someone just peeks and looks in your baby's mouth and was like, oh, there's no tongue tie.

How have they assessed the function?

So that's not really their job.

But whose job is it?

Well, that's a point of contention.

Not everyone knows whose job that is.

So I've taken it upon myself for my babies because I want them to have good feeding outcomes to teach all of my staff how to properly assess tongue function.

And at that point, we start talking, if there's impaired function, what could be the cause of it?

It's not always a tongue tie.

It could be multiple other things.

So that's a long answer to your question about what is a tongue tie.

But generally speaking, it's a piece of tissue under the tongue that restricts range of motion and function.

And it's interesting, too, because it goes both ways, right?

Like I was at the hospital with a family that had just had a cesarean.

We were trying to get the baby to latch, but I could it was struggling.

But I looked in there and I was like, oh, my gosh, like, I mean, it was making the indent in the tip of the tongue.

It was such a severe tongue tie.

And the problem was I can say, oh, I can see that we have a tie, but I don't know if that's going to cause an issue.

I can't promise that it actually needs to be revised.

Right.

So there are different grades and severities of them.

So can you kind of explain?

Sure.

You know, to make this a little bit even more confusing, there's two scales that people use.

I'm not sure if I'm pronouncing it right.

Speech language pathologists use one called Corrillus or Corrillo, something like that.

And it's the complete opposite of what the dentists use, which is Kotlo.

And so that's what I use.

We use Kotlo and this is what the pediatric dentist I work with uses.

Kotlo would say a tongue tie that's all the way to the tip that looks like a heart shape is a class four, four being the worst.

And then maybe like someone's piece of tissue under their tongue that you can't see, that is much further back.

When I say back, it's closer to underneath the tongue where it meets the floor of the mouth.

So it's not obvious.

That would be a class one.

The classes of the tongue ties only tell you where that little thin piece of tissue attach.

They don't tell you the functional impairment or how bad the tie is.

So assessing if a tongue tie is quote unquote bad or not or affecting you is never can be done with just a picture.

It must be done by challenging the oral motor skills.

And I know that's very, what's the word?

Like it's kind of like comprehensive.

And you're like, girl, you're not giving me like any black and white answers.

That's kind of the reason I wanted to chat with you guys is this is not a black and white thing.

This is a lot of like, there's a little bit of art that goes into it and you need lots and lots of experience to really give good counsel.

And so that, I mean, that might be something your listeners might be wondering is like, who are you?

And like, do you even have the authority to speak on this?

Cause I mean, I may or may not.

You'll have to see when I tell you like what I do.

You do, we know you do or we wouldn't have you on here.

But you can tell them why.

But like, you guys know me, but like someone else may not.

And I will tell you that, you know, my background is labor and delivery.

That has nothing to do with tongue ties.

And then being a lactation consultant, I thought I was gonna learn a lot about tongue ties in my credentialing process, but I learned zero.

And so then I have lots of parents who knew a lot about tongue ties, but it was so confusing cause I got lots of mixed information from every source.

So I decided to take quite a few expensive courses and go across the country and shadow people and get hands-on experience.

And then we did some more courses hands-on with my team who's here.

But then I was seeing so many mixed results.

Like some of my babies would do great with a tongue tie release and some of them wouldn't.

And they all looked so different afterwards.

And then I took this course, which I highly recommend anyone who's interested in learning more about tongue ties and who's a medical professional to learn about.

TOT's course is called Tethered Oral Tissues.

It's by Autumn Henning.

She's coming to San Antonio here in, I don't know, March or April, I think.

Just a couple weeks, yeah.

Okay, wonderful course to take.

And she went on to explain the importance of collaboration, that this is not one provider's job to, if you want your client to get results in a reasonable amount of time that lasts a lifetime, it's not a one-person show.

It's not just a lactation, it's not just a pediatric dentist, it's just not the ENT.

And you need to be brave enough to approach the other members who are caring for this baby and collaborate together to improve what you're doing, because you're always gonna learn things to make yourselves better.

And the first thing she challenged us on was post-op care.

And her approach to post-op care was different than what I was seeing here in Austin.

So I called several dentists in town who were doing releases on my clients, and I tried to kind of talk with them to see if they would be open to meeting and partnering and kind of brainstorming on how we can get best results for our babies.

And there was really only one doctor who was humble enough to even listen to me.

And so that was Dr.

Poplin, who you guys will hear from, or maybe already heard from.

And he is very, very humble.

And so like who else is gonna let some perfect stranger come into your practice and tell you like, hey, let's change your post-op care.

And like, let's change all the things.

I didn't tell you this, I don't think.

I don't think you know this.

About maybe two months ago, I had a person who actually had another doula as their doula.

And that doula is also a lactation consultant.

And, but they didn't get any advice from anyone.

They just went straight to a pediatric dentist when that pediatric dentist has a good reputation.

It's not Dr.

Poplin.

And they were told that they did need a revision.

They did a revision, release, sorry, a release, release, release.

They did a release and they came home and the baby did okay in office, but then at home would not even take a bottle.

Like it was just screaming.

She had no one to call and she's texting me.

I don't even know why.

I just know her from the community.

Like I've never served her in a business capacity.

And she's texting me saying, do you have anybody that can help me?

I need a lactation consultant because I can't get my baby to eat tonight.

And I was like, she goes, we just got our release today.

And I said, well, they didn't give you like an after hours number to call.

Like, did they not give you instructions on how to handle this?

And she goes, well, no, they told me like I would be fine and to follow up with the lactation if I need it.

And I was like, but you didn't have that ahead of time?

Like my mind was boggled that they didn't have somebody lined up to be able to speak with.

And here it was like a, it was a Tuesday night.

I remember cause I was teaching class and I'm sitting there texting Sam like, I know you live really far from them, but do you want to do a virtual with them tonight or something?

Because this mom's tripping.

Like she's really upset up, rightfully so.

But it was, wow, it was, there was no collaboration.

There was no plan ahead of time for what if this doesn't go well?

And you know, another lactation consultant was just gonna have to come in blind to what was going on.

And we don't know what post-op instructions they were given.

And I said, did they help you feed in office?

And she was like, well, yeah, he fed in the office.

And she was like, wow, I just felt awful for her.

And I had only worked with people who had gotten revisions with y'all or releases with y'all.

That's true.

If you only know the way we do it.

I knew I had this collaborative care.

I only had seen it the way it's supposed to be.

We're like the only one.

Yeah, we're the only one who does it like this.

A lot of people, it's different and we can get into that.

But you know, I have, I think it's Instagram or YouTube.

It's an Instagram video on like what you should look for when selecting a tongue tie provider and it was a lot of red flags.

Like if they can get you in right away, like same day, maybe that's okay.

But you might want to think about why they have an opening so soon.

If they are not giving you an after hours number, if they're kind of rushing you into doing something today, if they're not giving you post-op care, if they're not spending more than 20 or 30, like they should, the consultation should be 20, 30 minutes at least before you even consider doing a procedure and you absolutely need a post-op check.

So those are just some things.

But I was really grateful that I was challenged in that course I took to collaborate.

And then I was even more grateful to find a provider who was so open to just doing anything possible to improve the outcomes of his patients.

And that I will tell you, and when you talk to him, he will tell you that he doesn't do as many releases as he used to because I come in and I'm kind of like the soup Nazi.

And I'm like, no, no release for you because that's my whole goal is to prevent.

I am the girl.

Not all your people are gonna know who soup Nazi is, but that's not a designer.

You gotta Google it.

But I mean, my whole goal is to prevent premature or unnecessary procedures.

Cause many times because of the advent of social media and the internet, we're learning things from social media, but they're not comprehensive enough.

So when you see a post that says, if your baby's clicking, if your baby has gas, if your baby is leaking milk, then your baby probably has a tongue tie, go to a pediatric dentist.

That is such a halfway, I don't know how to say that nicely, but it is not a complete thought.

That is not a complete, that is not sound medical judgment.

So please don't get your medical advice from any social media.

Those symptoms, they absolutely could be a sign of a tongue tie, but I could think right now of four other reasons that they can be happening.

And so when someone comes into Dr.

Poplin's office, and I'll share why I'm even there to begin with in a minute, and they say, hey, my baby's leaking, clicking and has gas, I asked them a bunch of questions to try to figure out if this could be not related.

Then I look in the baby's mouth and challenge their oral motor function, take pictures, and then Dr.

Poplin comes in and does his assessment.

Many times we're gonna recommend non-cervical interventions first, and many times they work because it's not a tie significant enough to cause all those problems.

Those problems are caused from other things.

And so absolutely like on my website, we have milkdiva.com forward slash tongue dash tie.

There is a whole like step-by-step, what you should do if you suspect your baby has a tie, and the first step is not visiting a release provider, it is getting an evaluation from a non-surgical person.

So a feeding therapist, a lactation consultant, someone who specializes in working with babies with ties that can do non-surgical interventions first.

Well, you guys, as a mom who had postpartum anxiety and just typically a generally anxious person in general, I can understand why parents want to go to the provider who can get them in same day.

And why parents want to have the quick fix, which they think is going to be the release, because they don't want to take the time to fix all these other things, because that is really freaking overwhelming.

When you already have this newborn who's struggling to feed and who's waking up a million times a night and you're sleep deprived and you're like, you really seriously want to add a few more days of me trying more things before we can fix this thing?

And that's really hard.

So, you know, one of the questions also that we have for you is, you know, you just said it doesn't always need to be revised.

Does it always affect breastfeeding?

Is, does having some sort of tie always affect it?

Or does sometimes it's just not even applicable?

It totally doesn't always breastfeed.

So I, my role, the reason I can answer these questions with confidence is because at least one day a week, I work with a pediatric dentist.

And just as a disclaimer, I do work with Dr.

Poplin.

I do not get paid per phrenectomy.

I don't get any kind of financial incentive.

If we do a hundred phrenectomies or one, I get paid the same.

It's just like a salary.

Like one day a week, this is what I get paid to be in here.

And the reason he has me in there is to help improve outcomes.

And how do you improve outcomes?

Make sure you only do phrenectomies on babies who could really benefit from that.

Well, how do you know?

You need someone who can do a physical assessment in the mouth, Dr.

Poplin or the dentist.

He will look in there and say, this anatomy is outside of normal limits.

It is impaired, right?

So that's his role.

And then he'll talk about what the options are.

Should I do it now?

Should I do it later?

What are the pros and cons?

Anesthesia, no anesthesia.

No anesthesia.

Babies don't need anesthesia.

But all the questions that you might have from the surgical point of view, right?

Post-op care, what does the wound look like?

What are the risks of infection?

Blah, blah, blah.

But who does the functional assessment?

That is gonna be the person who's watching you feed.

I do not have time to do an hour and a half long assessment on all his patients there.

So many times they're coming from another lactation consultant, but I am there to help interview the client and the patient to make sure that they're psychosocially ready in their mind for what might be coming.

And then they've explored some other options as well.

And I answer all of their breastfeeding questions.

But your question was, can you have a tongue tie and still breastfeed?

And so, I mean, I easily see 15 patients a day that come in for tongue tie and lip tie evaluations.

And I see all different kinds of things in their mouth at all different ages, as long as they're less than a year old.

And the answer is absolutely, your baby can breastfeed perfectly fine with a tongue tie.

It just depends on so many factors.

So if you have a ton of milk, cause it's like your fourth baby and you just make milk as soon as a baby looks at you and you keep rocking until a year of life making all that milk, then yeah, your baby could totally live off the letdown forever.

That is not common though.

Live off the letdown.

I love that saying.

That's what we call it.

Yeah, they live off the letdown.

We had a client that had a baby home birth with a pretty good tongue tie.

And we were saying tongue, but there are also lip ties that also cause an issue.

And her baby was fine because it was her second baby and she was just like a magic milk maker.

And they didn't have to work so hard for them.

Yeah.

And so the question you need to ask, so I will say that I find that to be more common before the baby's four to six months of life.

After four to six months of life, your body's like, I don't think I'm gonna make this much milk if the baby's not gonna pull it out on their own.

They just start to naturally start to decrease in milk supply.

So if you wanna wait and see what happens, that's your choice too.

Generally speaking, babies with maybe class three or class four tongue ties, meaning more severe, don't breastfeed well.

That's generally speaking more common, but there's those cases where they can feed just well.

The issues you wanna think about though are, will this impair speech?

Will this affect their breathing?

Are they gonna need a ton of orthodontics?

Are they gonna be mouth breathers and just inhale all of the pathogens around them and all the allergens?

Because when you sleep with your mouth open, you don't have a filter and you're supposed to, getting some background noise.

Oh, you're supposed to filter all the air that you breathe through your nose, but if you're just have your mouth open and letting anything go in there, you end up having tonsil issues or upper respiratory infections.

So those are some things to think about, but I never, Dr.

Poplin and I never recommend a baby get a tongue tie release just because something like this might could happen in the future.

We're generally trying to improve.

We want a goal, like, mom, okay, what is your goal?

Tell me clearly, what is your goal?

And then we can tell you if we think this tongue tie will help you achieve that goal.

I had a parent come in the other day, tell me her goal was that her baby is multi-linguistic.

No, okay, it's a big goal, real early on.

Hey, well, your baby at that point had a class two tie, so right in the middle of the tongue, very tight.

Baby had a thick white coating on the back part of their tongue and had significant difficulties breastfeeding, so there's multifactorial deficits there, right then and there, just showing, just peeking his head early on in life.

So then for your baby to speak multiple languages, I have actually no idea if your baby will speak multiple languages, and I tell people, I don't know, I don't talk with, I don't work with kids that talk or have teeth.

Dr.

Poplin does.

So Dr.

Poplin will have to answer that for you, and we'll see what he says.

But when it comes to compensating, your baby is definitely compensating, and so when they're compensating with feeding, they have less reserves to compensate with other stressors in their life.

And so if your goal is to get back to breastfeeding, then yes, I think a tongue tie release for this case would be important.

And in addition, she told me it was taking her baby an hour to bottle feed.

And so then I ask a million questions about what kind of bottle and how much milk and blah, blah, blah.

And so that in itself is another feeding deficit.

So my recommendation was yes, I think your baby could benefit from a tongue tie release as long as you work with a provider to help teach your baby how to use his tongue properly after the procedure, because it can help breast, or excuse me, bottle feeding be more efficient.

And then the next thing is solid food.

So babies with tongue ties sometimes lean more towards soft mashable foods, mashed potato, mac and cheese, pasta, yogurt, and will stay away from textured foods because they're not able to move the food in their mouth properly side to side from their tongue to their teeth.

And so all of those things we have to consider when making a recommendation, Dr.

Poplin and no dentist that I know has time to sit there for 30 minutes with you and go over all these things.

So that's how we take a tag team approach to how we do our consults with the patients when I'm with Dr.

Poplin.

He's not in my lactation consultation.

So when I do my 90 minute lactation consultation, it's private, that's just me and my patient.

He's not there, but we have one day a week where we do babies together.

And I'm like 20 minutes with the patient, he's 20 minutes with the patient, and then we make a decision what we're gonna do.

So I have kind of a, not argumentive, but like, you know, hearing it out, quick question.

You said you don't always recommend that they revive, sorry, release.

And if you, because they need to try some other things first.

However, even if they try those other things, I mean, if they have a tie, they have a tie.

So you're saying it can affect these other things later on in life.

So wouldn't it still be beneficial to get it released?

Good question.

Even if they have those other problems?

So I should probably clarify.

If your baby comes in with a gnarly tie, right?

Like class four, a heart-shaped tongue, you know, I'm sorry, there's only so much chiropractic and lactation help could do for that.

They're gonna need to get released.

So I feel like when it's so obvious, let's release this baby and let's go ahead and do these other things as well to make sure you meet your goals.

That's like a no-brainer.

Even a class three, I feel like is a no-brainer.

As long as the parents are mentally prepared to do the post-op care.

So if you come in with a class four and a class three tie and a super gnarly and I think your baby's gonna have speech and feeding and all the things problem, if you cannot demonstrate the competence to get your fingers in your baby's mouth and lift that tongue and do the post-op care six times a day for four weeks, then what I'll do is I'll give you homework and I'll say, okay, over the next week, here's a video, let's do this together here.

Let's practice this at home.

And then if you feel comfortable doing this for the next four weeks, come back in and then we will do the release.

Having an approach like that before you do a release helps the post-op care be a lot less traumatic for the baby.

I know there's a big push on like tongue tie releases and aftercare shouldn't be traumatic.

And that would be true if people knew to start getting your fingers in your baby's mouth and lifting that tongue before you had the procedure because then your baby just is like, this is what we do.

We have a diaper change, mommy lifts my tongue and I don't freak out.

But if the first time you do it is when the baby has a little boo boo in there, she gonna cry, you gonna cry, you're gonna second guess your whole decision and it's gonna reattach and you're gonna end up worse off than you were before.

Yes, babies cry if you put your finger there anyway, right?

That's what they're not realizing.

It's the first time you're trying it is when they have a boo boo in there, like you said.

So of course they're crying, but they were actually gonna cry and because they have to take your temperature under their armpit.

Absolutely, or change the diaper.

So that's another thing that we do a little differently is parents get in there with me and we get gloves on and we get our fingers in the mouth before a parent makes a decision about what they wanna do.

So my recommendation is gonna be based on lots of things.

Most of it is gonna be parent readiness.

Now, if the baby's tie is about a class one or two and it's like, I think these feeding issues could be caused because your baby has torticollis, let's say, like they're born and their head is like cocked to one side and they can't really turn it really well.

And a mom is telling me they're having pain with breastfeeding.

A lot of the times the number one thing I hear is, well, the gassing part, they come in for gassiness.

They come in because their nipple comes out lipstick shape when their baby unlatches.

And so they heard that that is a sign of a tongue tie.

So what I will share with you is any baby with a perfect tongue who you just put your finger in the corner of the mouth and you take them off the breast, your nipple will come out compressed.

It will look like a lipstick.

Any baby with a perfect tongue, unless you get your finger under the tongue and break the seal where you hear a sound that sounds like this, that is the only way your nipple is gonna come out round.

So just because you come in and tell me your baby gives you lipstick shape nipples, to me, that's not enough, because I wonder how much of that is improper unlatching technique, because no one never taught you.

How are you supposed to know?

Most of the time they tell you just to put your finger in the corner of the mouth, but that does not break the seal.

And all that does is cause the nipple to come out compressed.

So I will put a link or I'll give you a show note link, maybe that you could put in of a video I have demonstrating how to properly unlatch your baby, to see if you can get a round nipple when you unlatch.

But all of those things can be explored by a lactation consultant and it's non-surgical.

And so your question was, hey, Naomi, if you know all these other future issues could happen, why wouldn't you recommend a recommendation?

Excuse me, why wouldn't you recommend a release?

And it is nuanced.

If your baby's tie is very obvious, I will sit down, Dr.

Poplin, I will both sit down and say, these are some things that your baby could face.

You have the choice of releasing, because some people are like, I don't even want a breastfeed anymore.

I'm just here because I was told I should come here.

And so we will say you have the option of releasing the tongue now and hopefully preventing those issues.

Or if your baby has those issues, you can come back and you can get it released too when he's four years old, if you like, or three years old too.

It's not like you missed the boat.

But Dr.

it is very difficult to release kids that are between like one and two and a half years of life.

So there's a little window where you can't do it, but then you can do it again.

So it's not like a rush, like a one-shot deal.

You can only do it when your baby is a baby.

If not, you miss forever.

No, you can do it later too.

So we leave it up to the parent.

That makes sense.

I think that, you know, like when I'm talking with a client, you know, with one of our clients and we think there might be something going on, we do hear it because it is such a common thing right now and almost a little bit of a buzzword with ties and different things.

So many people are like, well, I think baby has a tie, so we definitely need to jump and get all of that figured out immediately.

And it's like, yeah, but also we want to start with the least invasive stuff first.

And also, you know, the least expensive things too, revisions, releases, all these things, they're not cheap.

It's, you know, it's that's an expense.

And if we can save you that and if we can save the work that that is and the discomfort for baby and for you, that's definitely the preferable method before we just jump into, you know, these high intervention things.

And that's wonderful that they exist and that we have the tools and we have the post-op care and we have the support to be able to do that.

And so when it's being recommended, it's absolutely fantastic, but doesn't necessarily need to be the first stop on our on our list.

So I think it's very nuanced.

Yeah, it's important for people to know that.

And just because your dentist says, yeah, I could do that today, doesn't mean that necessarily that's what we need to do immediately.

And I am going to say a couple of things, you know, a tongue tie release procedure, you know how the definition of tongue tie is not black and white, like there's not one agreed upon definition of a tongue tie release procedure.

The same thing with the procedure, so it's not like, oh, I'm going to get a knee replacement, a knee replacement is a knee replacement, a knee replacement or like a disectomy.

Like it's you're doing like that's a very clear cut.

Like when I say clear cut, it's done the same way.

The same technique is used every single time.

A tongue tie release procedure is not like that.

It is much more of an art form.

And what I mean by this, because I've seen thousands of releases by now from several different providers and also Dr.

Poplin and I, he more often than I do, speaks nationally and internationally teaching other providers all the things about lasers and laser procedures.

We had the opportunity to speak on a national conference in October together on collaborative care and getting the best results for your baby.

It was called like A to Z Phrenectomy and Infant Care.

But the person who's doing the procedure, so if you do it, there's different kinds of lasers and different kinds of techniques.

So you can use a scissor.

You can use something called a diode laser or a mini laser.

There's lots of different names for that.

That's not a real laser, I'm going to tell you.

And I almost rather you just not get it done than get it done with that kind of a tool.

It's almost like cautery.

It causes burning.

It can be very traumatic to the surgical site.

And then there are CO2 lasers.

So there's that's that first piece of information.

And then the second piece of information is some providers, you know, may not do what we call a full release or a little bit, maybe not as experienced or a little bit apprehensive to go as deep as you might need, especially with someone who has a posterior tongue tie.

And that is what sold me on the provider that I said, you know, I usually work with as he has.

He's like this little special technique that he does.

And I've never seen anyone else do it.

I'm not going to give away his little, whatever you call that trademark secret.

But that's why I was like, why am I always getting better results with this provider than with other providers?

And that could change, you know, at any time.

But like other people might learn different techniques, but I just get the better result with the way that he does it.

And then the next thing I'll say is when it comes to cost is if you think your baby has a tongue tie, put your baby on your dental plan before they hit 30 days of life.

Because many times, depending on the office that you're at, I know that at Dr.

Poplin's office, they'll submit the claim for you.

And many times they'll take your dental insurance.

If they don't take your dental insurance, they'll submit the claim.

So you pay first and then you just wait for the dental plan to reimburse you whatever they're going to reimburse you.

And of course, that can change at any time too.

But that's something people don't realize.

That's huge and definitely good to know we had a whole conversation about just the cost of releases the other day.

So I think that's awesome to hear.

I think this has been just incredibly valuable and like you've mentioned a couple of times, we are going to have Dr.

Poplin on our next episode to go over what the release looks like and kind of that whole process.

So definitely tune in on next week to be able to hear about that.

But we thank you so much for coming on and sharing about all of this.

It's cool to hear kind of what the process looks like and why and how y'all are doing it differently.

So thank you so much for joining and we'll have links in the show notes for people to reach you.

But do you want to tell everyone where they can find you on social media?

Oh gosh, I just got to remember my handles.

Let's see.

I am at Milk Diva somewhere.

Milk underscore Diva on Instagram, Milk Diva basically everywhere.

Our website is milkdiva.com and yeah, you can find us there.

And then I think that's it.

And she has an amazing podcast as well.

Yeah.

Oh yeah, the podcast, we do have several episodes on tongue ties if you want to learn more.

Like there's actually one with Dr.

Poplin, I think is episode 31.

And then there's other podcasts that talk about bodywork and tongue ties.

So there's a lot of resources there.

I'll put the, I'll send you the links.

Perfect.

Thank you so much for joining us and we'll talk again soon.

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