A ‘Triple-Care’ Approach To Infant Feeding Challenges
It is well known that breast feeding up to and beyond 12 months of age improves health outcomes for both infants and mothers.1 Lesser known advantages include nurturing the gut microbiome,2 cognitive benefits3, prevention of the onset of sleep apnoea4 and its sequelae cardiovascular disease; as well as positive impacts on craniofacial structures with reduction in dental cross-bites and other forms of malocclusion5. Healthcare initiatives aimed at supporting functional feeding dyads are essential for a preventive, rather than reactive model of care.
The current standard of care during feeding challenges is often a ‘watch and wait’ approach, or advice to bottle feed, despite the presence of oral ankylofrenula (including tongue tie), which often goes undiagnosed and is proven to cause feeding difficulties (references available), resulting in premature non-elective cessation of breast feeding and subsequent loss of known health benefits.
Currently, only around 21% of Australian children are breastfeeding at 12 months (references available), with an even smaller percentage feeding optimally. Three professions which offer feeding support for infants, include International Board Certified Lactation Consultants (IBCLC), paediatric manual therapists, and surgeons offering frenectomies when necessary. While studies have shown each of these therapies to improve feeding outcomes independently of each other (references available), such modalities are not routinely utilised in our current paradigm of care and rarer still, are they used in combination with each other. There are however some teams offering this approach. These include The Gold Coast Tongue and Lip Tie Clinic on the Gold Coast.
Dr Dan Hanson: 
http://www.drdanhanson.com/goldcoast-tongue-lip-ties
Myofocus in Melbourne : https://www.myofocus.com.au/laser-tongue-lip-tie/
Timely referral to an ‘integrative unit’ of all three types of practitioners can facilitate profound improvements in feeding function and this ‘triple-care’ approach to correction of oral anykylofrenula has been shown to be highly effective clinically. As a result, there are a growing number of clinics, within Australia and overseas which deliver this integrative ‘triple care’ approach.
We hope this will lead to an evolution in the current paradigm, with more practitioners offering a ‘combined approach’ to care, with resulting improvements in the health of the next generation.
Author: Dr D Hanson B.D.S.
References:
- Paediatrics 2005; 115;496. DOI: 10.1542/peds.2004-2491. Breastfeeding and the Use of Human Milk.
http://pediatrics.aappublications.org/content/pediatrics/115/2/496.full.pdf - JAMA Pediatr. 2017 Jul 1;171(7):647-654. doi: 10.1001/jamapediatrics.2017.0378.Association Between Breast Milk Bacterial Communities and Establishment and Development of the Infant Gut Microbiome.
https://www.ncbi.nlm.nih.gov/pubmed/28492938 - J Korean Med Sci. 2016 Apr; 31(4): 579–584. Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810341 - ERJ Open Res. 2016 Jul; 2(3): 00043-2016. A frequent phenotype for paediatric sleep apnoea: short lingual frenulum.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034598/pdf/00043-2016.pdf - 5. Am J Orthod Dentofacial Orthop. 2010 Jan;137(1):54-8. doi: 10.1016/j.ajodo.2007.12.033. Relationship between breastfeeding duration and prevalence of posterior crossbite in the deciduous dentition.
https://www.ncbi.nlm.nih.gov/pubmed/20122431
