Page 6<strong>Breastfeeding</strong>: Best for Baby <str<strong>on</strong>g>and</str<strong>on</strong>g> MotherCONGENTIAL TONGUE-TIE [CONTINUED FROM P 4]References: (C<strong>on</strong>tinued)6. Emmanouil-Nikoloussi E, Kerameos -Foroglou C. <str<strong>on</strong>g>C<strong>on</strong>genital</str<strong>on</strong>g> syndromes c<strong>on</strong>nected with t<strong>on</strong>gue malformati<strong>on</strong>s.Bull Assoc Anat (Nancy). 1992;76:67-727. Fletcher SG, Meldrum JR. Lingual functi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> relative length of the lingual frenulum. J Speech Hearing Res 2.1968;382-3908. Genna CW. <strong>Breastfeeding</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> t<strong>on</strong>gue-tie. Leaven. 2002;38(2):27-299. Glass RP, Wolf LS. Incoordinati<strong>on</strong> of sucking, swallowing <str<strong>on</strong>g>and</str<strong>on</strong>g> breathing as an etiology for breastfeeding difficulty.J Hum Lact. 1992;10(3):185-18910. Hazelbaker AK. Assessment Tool for Lingual Frenulum Functi<strong>on</strong>. Columbus, OH: Privately printed;1992.11. Hingley G. Ankyloglossia clipping <str<strong>on</strong>g>and</str<strong>on</strong>g> breastfeeding. J Hum Lact. 1990;6:10312. Jain E. Video: <str<strong>on</strong>g>T<strong>on</strong>gue</str<strong>on</strong>g>-tie: <str<strong>on</strong>g>Impact</str<strong>on</strong>g> <strong>on</strong> <strong>Breastfeeding</strong> [videotape]. Calgary, Alberta, Canada: Lakeview <strong>Breastfeeding</strong> Clinic;199613. Kotlow LA. Ankyloglossia (t<strong>on</strong>gue-tie): a diagnostic <str<strong>on</strong>g>and</str<strong>on</strong>g> treatment qu<str<strong>on</strong>g>and</str<strong>on</strong>g>ary. Quintessence Int. 1999;30(4): 259-26214. Lalakea ML, Messner AH. Ankyloglossia: does it matter? Pediatr Clin North Am . 2003;50:381-39715. Lalakea ML, Messner AH. Frenotomy <str<strong>on</strong>g>and</str<strong>on</strong>g> frenuloplasty: if, when, <str<strong>on</strong>g>and</str<strong>on</strong>g> how. Otolaryngol Head Neck Surg. 2002;3:93-9716. Marmet C, Shell E, Marmet R: Ne<strong>on</strong>atal frenotomy may be necessary to correct breastfeeding problems. J Hum Lact.1990;6(3):117-12117. Messner AH, Lalakea ML, Aby J, MacMah<strong>on</strong> J, Bair E. Ankyloglossia: incidence <str<strong>on</strong>g>and</str<strong>on</strong>g> associated feeding difficulties. ArchOtolayngol Head Neck Surg. 2000;126:36-3918. Messner AH, Lalakea ML. Ankyloglossia: c<strong>on</strong>troversies in management. Int J Pediatr Otorhinolaryngol. 2000;54:123-13119. Mukai S, et al. Ankyloglossia with deviati<strong>on</strong> of the epiglottis <str<strong>on</strong>g>and</str<strong>on</strong>g> larynx. Ann Otol Rhinol Laryngol Suppl 1991;153,3-2020. Palmer B. The Influence of breastfeeding <strong>on</strong> the development of the oral cavity: a commentary. J Hum Lact.1981;14(2):93-9821. Ross MW. Back to the breast: retraining infant suckling patterns. Lactati<strong>on</strong> C<strong>on</strong>sultant Series; Wayne, NJ; AveryPublishing Group;198722. Salloum, AC, MD, MA. Student IV paper for “Medicine in C<strong>on</strong>temporary Society.” St<strong>on</strong>ybrook Medical School, SUNY; 200323. Wiessinger D, Miller M. <strong>Breastfeeding</strong> difficulties as a result of tight lingual <str<strong>on</strong>g>and</str<strong>on</strong>g> labial frena: a case report. J Hum Lact1995;11(4):313-31624. Wolf LS, Glass RP. Feeding <str<strong>on</strong>g>and</str<strong>on</strong>g> Swallowing Disorders in Infancy: Assessment <str<strong>on</strong>g>and</str<strong>on</strong>g> Management. Tucs<strong>on</strong>, AZ; AcademicPress, Inc; 199225. Woolridge M. The anatomy of infant sucking. Midwifery. 1986;2:164-171
Page 7<strong>Breastfeeding</strong>: Best for Baby <str<strong>on</strong>g>and</str<strong>on</strong>g> MotherNATIONAL BREASTFEEDING AWARENESS CAMPAIGN [CONTINUED FROM P 1]<strong>Breastfeeding</strong> promoti<strong>on</strong> efforts havebeen successful in getting women tobreastfeed, but the payoffs of betterhealth remain less than optimal withoutthe commitment to exclusive breastfeedingfor 6 m<strong>on</strong>ths. 2The U.S. Department of Health <str<strong>on</strong>g>and</str<strong>on</strong>g> HumanServices through the Office <strong>on</strong>Women’s Health (OWH) worked with theAdvertising Council to create public serviceannouncements for televisi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g>radio <strong>on</strong> the importance of exclusivebreastfeeding for the first 6 m<strong>on</strong>ths of life.In additi<strong>on</strong>, print advertisements werecreated for newspapers, magazines <str<strong>on</strong>g>and</str<strong>on</strong>g>billboards.Specific requirements were establishedfor the selecti<strong>on</strong> of informati<strong>on</strong> used in theadvertising campaign: well-designed studiespublished after 1990, studies fromdeveloped countries, breastfeeding durati<strong>on</strong>of at least six m<strong>on</strong>ths <str<strong>on</strong>g>and</str<strong>on</strong>g> samplesizes of 100 children or more. The studieslooked at the effects of breastfeeding <strong>on</strong>the incidence of diarrhea, hospitalizati<strong>on</strong>for respiratory illness, obesity/overweight<str<strong>on</strong>g>and</str<strong>on</strong>g> otitis media. For a reference list, seepage 8.Public health experts are hopeful the campaignwill go far to shift the Americannorm from formula feeding with <str<strong>on</strong>g>and</str<strong>on</strong>g> withoutbreastfeeding to breastfeeding withoutthe need for supplementing with formula.A campaign dealing with any aspect ofchild health <str<strong>on</strong>g>and</str<strong>on</strong>g> welfare requires the cooperativesupport of pediatricians to makeit a success. This campaign is no different.The U.S. public health system iscounting <strong>on</strong> pediatricians to provide thenecessary support for women who resp<strong>on</strong>dto the campaign <str<strong>on</strong>g>and</str<strong>on</strong>g> choose tobreastfeed, as well as women who havequesti<strong>on</strong>s, problems or want the campaign’smessage validated.Members of the AAP Secti<strong>on</strong> <strong>on</strong> <strong>Breastfeeding</strong>Leadership Team worked with the OWHto provide scientific expertise for the campaign.In additi<strong>on</strong>, several pediatricians areinvolved in 18 community dem<strong>on</strong>strati<strong>on</strong>projects (CDP) funded by the OWH to enhancethe campaign’s impact. The followingcities have a CDP:• Atlanta, Georgia• Birmingham, Alabama• Bost<strong>on</strong>, Massachusetts• Camden, <strong>New</strong> Jersey• Chicago, Illinois• Kansas City, Missouri• Knoxville, Tennessee• Los Angeles, California• <strong>New</strong> Orleans, Louisiana• Philadelphia, Pennsylvania• Portl<str<strong>on</strong>g>and</str<strong>on</strong>g>, Oreg<strong>on</strong>• Providence, Rhode Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>• Pueblo, Colorado• San Juan, Puerto Rico• Rosebud, South Dakota• San Francisco, California• St. Paul, Minnesota, <str<strong>on</strong>g>and</str<strong>on</strong>g>• Washingt<strong>on</strong>, D.C.To find a CDP near you, call 1-800-994-WOMAN (9662).There are a number of steps pediatricianscan take to get involved. The first is to beprepared to validate the campaign. Mothersshould feel the messages they hear orread are shared by all of the professi<strong>on</strong>alswho care for them <str<strong>on</strong>g>and</str<strong>on</strong>g> their babies. Pediatriciansalso can support the campaignby:• Affirming to mothers that theAAP supports breastfeeding asthe optimal nutriti<strong>on</strong> for infants.• Explaining why a campaign isneeded in the United States atthis time. For instance, tell mothersthat that despite high initiati<strong>on</strong>rates of breastfeeding, lowdurati<strong>on</strong> rates persist. Also, explainthe importance of exclusivebreastfeeding.• Encouraging all mothers, withrare excepti<strong>on</strong>s, to breastfeedexclusively for about six m<strong>on</strong>ths,which means delaying otherfoods or fluids, <str<strong>on</strong>g>and</str<strong>on</strong>g> to c<strong>on</strong>tinuebreastfeeding thereafter for asl<strong>on</strong>g as mother <str<strong>on</strong>g>and</str<strong>on</strong>g> child desireit.• Coordinating community resourcesto support mothers,such as the CDPs, or referringthem to the OWH-funded free<strong>Breastfeeding</strong> Helpline (1- 800-994-WOMAN) or Web site(www.4woman.gov), which hasextensive informati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> helpfor breastfeeding mothers.• Working collaboratively withmembers of your health careteam to assess <str<strong>on</strong>g>and</str<strong>on</strong>g> managebreastfeeding support.• Scheduling the first ambulatoryvisit by a qualified observer forall breastfed newborns at 3 to 5days of life.• Enhancing your knowledgeabout breastfeeding <str<strong>on</strong>g>and</str<strong>on</strong>g> skills forassessment of breastfeeding byattending c<strong>on</strong>tinuing medical[c<strong>on</strong>tinued <strong>on</strong> p 8]