FAQ: For Mother and Mother-to-be

How do I access the services of the Center for Breastfeeding?

Breastfeeding families are seen by appointment.  See here (http://cbn.med.ufl.edu/) for our hours and locations.  Typical appointments are an hour in length.  Fathers, grandparents, and other support persons are welcome to attend.

How are services billed?

Since breastfeeding issues often affect both mother and baby, both mother and baby are scheduled as “patients”.  This also allows for an accurate record of all of the care each individual receives, including any prescriptions that may be written.  Insurance is billed for both mother and baby.  Medicaid is accepted.

Can I just call to ask for advice?

At this point, the Center for Breastfeeding is a one person clinic.  Mary Ryngaert, ARNP IBCLC, is the provider in the clinic and Sandra Sullivan, MD IBCLC, is a neonatologist who has responsibilities to the critically ill infants in the NICU.  The outpatient clinic visits keep Mary away from the phone most of the day.   We suggest making an appointment if you are experiencing difficulties.

What is tongue tie and how does it affect breastfeeding?

A tongue tie is a thin band of tissue that tethers the tongue to the floor of the mouth.  It may be anterior (attaching close to the front of the tongue) or posterior (at the back of the mouth).  Breastfeeding problems may develop if a tongue tie keeps the baby from having a good seal at the breast and working the tongue correctly to efficiently transfer milk.  Among these are significant maternal nipple pain and damage, poor weight gain, and eventually reduced milk volume if the baby does not fully empty the breast.

What can be done about tongue tie to help breastfeeding?

Sometimes it is just a matter of finding a position that allows the baby to latch well and transfer milk well.  Sometimes, a procedure called a frenotomy, or a tongue tie clip can help.

What is involved in a frenotomy?

The procedure can generally performed in office.  There is no need for the baby to be put under anesthesia.  The clip is done with sterile scissors and the baby is put to breast quickly after the procedure.  The clipped area heals easily and the baby typically feeds well and acts normally after the procedure.

Are there any risks to frenotomy?

As with anything, there are risks involved.  But frenotomy is usually a safe procedure that improves breastfeeding comfort and efficiency.  Risks include:

  • Bleeding from the frenotomy site (usually just a little for a few minutes)
  • Pain (although most babies seem to feel fine quickly after the procedure)
  • Failure to improve problem-sometimes breastfeeding still hurts and/or the baby still does not transfer milk well.
  • The clipped area may scar back down or there may be additional tongue tie tissues that persists after the frenotomy.  In that case, a second clip may be beneficial.

What type of follow-up should I expect after frenotomy?

It is helpful to schedule a follow-up visit to re-evaluate the tongue tie and breastfeeding about a week after a frenotomy.  Occasionally, a baby may need some help from our Occupational Therapist to improve the suck/swallow.  We can set that up through Breastfeeding clinic.

Why go to Center for Breastfeeding and Newborns for frenotomy?

Dr. Sandra Sullivan and Mary Ryngaert, ARNP MSN are both pediatric providers who are also International Board Certified Lactation Consultants with extensive experience in the treatment of tongue ties for the benefit of breastfeeding.  Dr. Sullivan is a member of the International Affiliation of Tongue Tie Professionals, which is working to standardize the definition of tongue tie and to educate professionals about the frenotomy procedure.  Watch a video of Dr. Sullivan discussing frenotomy.