Concorde way to breastfeed: Video and FAQ’s

The Concorde way of latching on in breastfeeding was developed for tonguetied babies and their moms. It appears to be a usefull alternative hold with many other breastfeedingissues. There is a video about it which can be found here.

And these are the most frequently asked questions with an answer:

Does this hold make clipping buccal ties unnescessary?

Will this way of latching work for every breastfeedingproblem?.

With which breastfeeding issues may this hold be effective?

It is correct that mom’s fingers are so very close to babies mouth?

What about an increased risk of blocked ducts?

Why do you think baby learns to drink well this way?

Do you need to keep supporting the breast the whole feed?

Can you really correct latch without taking baby off the breast?

How can you use this concorde way of feeding after a c-section?

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Cutting the mast?

I regularly hear an analogy of a sailing vessel to explain why it is important to treat a tonguetie invasively. In this analogy the tonguetie is the sail. Only freeing the superficial tie (the sail) would be inefective because the stiff base of the tie (the mast) remains and hinders movement. Cutting through the mast is therefore important for a succesfull treatment.

Now I am not a Sailor, but I have sailed. And I know that on a sailing boat you do explicitly not want to cut your mast. No mast no sailing vessel, and without a mast sails are a useless pile of fabric. The analogy seems therefore to be essentially not fitting the desired message.

This can mean 2 things:

  1. The analogy is not functional. If the ‘mast’, the stiff base of the tonguetie, indeed needs to be released, then a sailing vessel is not the model to explain that.
  2. The sailing vessel is a usefull analogy and that implies we need to treat with care and more knowledge is needed.

We could look at the sailing vessel with the tongue as a sail, the boat as the base of the mouth and jaw. In which case the rigging (the ropes connecting the sail to the boat) is the tonguetie.

And then releasing the tonguetie makes sense. Because rigging* that is too tight hinders the mobility and maneuverability of the boat. Loosening a rigger improves the functionality of the vessel. Provided one leaves the mast standing. No mast no sailing vessel.

Tonguetie treatment is going deeper and deeper into the mouths of very young babies Treating a tonguetie is a very old procedure recorded even in the Bible. But as far as I know this was never before done so invasively. In the old literature there appears to be no mention of diamond shaped wounds and aftercare.

Althoug we see clear improvement in breastfeeding and oro facial mobility at short term we do not know what the long term effects are going to be. We can not know the effect after 5, 10 or even 50 years for the simple reason that the procedure in the current form has not been performed long enough. In other words: we do not know what the effect of cutting the mast will be in the long run.

Primum non nocere: do no harm. We either need a better analogy, or the sailing vessel analogy indicates that treatment needs to be done with great care. Tonguetie treatments is proven effective, but how invasive it needs to be done should remain high on the agenda of every provider.

* and even then not every bit of rigging!

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He asks me what kind of work I do. We meet over a glass of wine at a party. He is in his late sixties, h

as no children and never been involved in any, so my answer ‘lactation consultant’ doesn’t mean anything to him. ‘Whát do you do’?

And when I explain I assist mothers and babies with breastfeedingissues his next question is ‘What do you actually dó then’?

I tell him how mother co


ntact me for example with painfull nipples. And he wants to know more: what do I do then? So I show him on my fingertip what a difference it makes if pressure is applied to the top (uncomfortable and flow is blocked) or beyond (increased flow and comfort). And how a fingertip is actually similar in size, flow and sensitivity. And that increasing flow and comfort can make breastfeeding a more rewarding experience for mother and child.

“I see’, he says, ‘yo

u are some kind of plumber then. Milk needs to flow freely without any leaks’. Well… yeah, in that sense I am some kind of plumber.

But there is more, I explain. It’s not just technical. As a minimum I have 2 clients, mother and child. And if breastfeeding is not working well an important part of my job is to help them find the cooperation to form a team (again). And then there’s the network around mom and baby

: partners, family, healthcare professionals who need to be involved. Moreover there are also issues that deal with the autonomy of the baby more than with technique, such as bottlerefusal. Then it is my job to help the parents work with the baby to find a good solution that suits the whole family-team.

‘I see’, he says. ‘So you are also a mediator. You’re a plumber/mediator’.

He is happy he understands what I do for a living, and we contently enjoy our wine. Shall I put this title on my businesscard?

Posted in General, Breastfeeding, Breastfeeding, Lactatiekundige | 2 reacties

(Nederlands) Er bestaat een Kraamheks

Sorry, this entry is only available in Dutch.

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Out of office

In august I’m taking a sabbatical in order to prepare classes and write, and at last work on video-material.

In september I’m on vacation. Normally I’m happy to follow-up on my clients while on vacation but this year that is not an option as I’ll be on the Northsea. By limiting new clients in August I can provide the level of (after)care I normally offer.

And since classes that were planned for September had to be rescheduled to October… I’ll only be back to normal at the end of that month.

My apologies for any inconvenience.

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Breastfeeding and the microbiome

‘Does it make any sense to continue giving the breast now that I have used a breastpump?’

It was obvious my client had read an article in the NRC newspaper on research outcomes  on microbiome and breastfeeding. She had not digested all the details but the gist was clear: after expressing with a pump once the microbiome of breastmilk supposedly changed for the worse. There would be more dangerous-sounding bacteria in her milk, and less biodiversity, and the effect would be lasting. This gave her the impression that breastfeeding after expressing as she had done was useless. lees verder

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(Nederlands) Masterclass Concorde

Sorry, this entry is only available in Dutch.

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The new privacy law AVG/GDPR and my practice

While I am on vacation the new law will be mandatory. So here is an overview of the information I collect when you contact me:

After registration for a workshop:

  • Name, email and/or phonenumber so I know how many people will come and so I could inform participants of any chances should that be nescessary.

At registration as a client for help with breastfeeding

  • Name of mother, birthdate, email, phonenumber and streetadress. The latter so I can send an invoice which will be acceptable to an insurancecompany, and in case of a homevisit so I know where to go.
  • Name and date of birth of the child(ren).

After the visit I add:

  • Relevant notes about parents and child(ren) for follow-up
  • The summary I send the client after the visit.

Of colleagues and trainees I only keep contactdetails on my phone and in my mailbox in order to be able to reach them when needed. I do not keep a mailinglist of any kind.

I don’t:

  • Write newsletters, so do not keep a mailinglist of any kind
  • Register the BSN of clients
  • Register insurancedetails like name of company or registrationnumber.


  • Registration for classes and appointments for private visits are processed by, sent through by and processed into my CMS
  • Name, adress and email are then also stored in my bookkeeping program
  • My FBpage and my site autmatically register visits and clicks. As far as I know neither me nor the person who built my site have added any additional trackingcookies or other privacy invading stuff.

I hope for now this is sufficient to comply with the AVG. Do you miss anything? Do let me know.

If you want to see what data I collected about you personally you can contact me in any way you choose and I’ll show you. Once you’ve proven you are who you say you are of course :)

Want to print this text? You can, but I haven’t translated it yet.

thumbnail of Wet AVG

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(Nederlands) Leuk? Niet altijd.

Sorry, this entry is only available in Dutch.

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Did I say that?

[English translation pending] ‘Dat heb ik echt niet gezegd!’ denk ik verontwaardigd. Bij toeval kom ik online een oud cliënte tegen die me een op zich leuk berichtje stuurt. Ze schrijft dat ze uiteindelijk ruim 7 maanden met plezier gevoed heeft. En dat ze zo blij is geweest met mijn opmerking die ze aan veel vriendinnen heeft doorgegeven. “Ongeveer een week door de pijn heen bijten en dan gaat het over’.

Mijn eerste reactie is haar laten weten dat ik dat nooit maar dan ook nooit gezegd zou hebben. Maar vlak voor ik het bericht wil verzenden stop ik. Want ik vraag me af wat ik dan wel gezegd kan hebben. Kennelijk heeft zij dit gehoord. Het houdt me bezig want het is echt niet de bedoeling dat dit soort adviezen de ronde doen.

En dan zit ik weken later bij een andere cliënte met aanlegproblemen en op een tepel venijnige melkblaren/verstopte melkuitgangen. Twee duidelijke witte puntjes op de top van haar tepel.  Ze heeft ze op eigen initiatief al 2 x geprobeerd door te prikken maar dat gaf vooral een druppel bloed en nauwelijks verlichting. Met beter aanleggen is de pijn tijdens voeden aan beide borsten meteen minder, maar in de borst met de plekjes steekt het en dat is na de voeding nog lang voelbaar. En dan hoor ik het mezelf ineens zeggen: ‘Deze pijn is niet meteen over, het kan nog een of zelfs 2 weken duren voor het echt weg is dus dat is helaas een kwestie van nog even volhouden’.

Ah. Daar is ‘ie.

We spreken het beleid door:

  • Eerst aandacht voor (veel) beter aanleggen. Daarmee wordt de tepel niet meer afgeklemd en kunnen de blaren/verstoppingen hopelijk vanzelf genezen en doorstromen.
  • Als aanleggen zo goed gaat dat haar tepels niet wit maar rond en roze zijn na voeden dan kan ze proberen voor voeden de huid warm en vochtig te maken zodat haar dochter de blaartjes/verstopping makkelijker weg kan drinken.
  • Aanprikken kan ze nog eens proberen als ondanks dat na 2-4 dagen de pijn bij aanleggen duidelijk veel minder is maar de plekjes er nog zitten.
  • Verder lecithine nemen en als de pijn tussen voedingen in de komende dagen nog te aanwezig is paracetamol of ibuprofen gebruiken.

Zij is opgelucht en blij met een plan, haar partner heeft meegekeken en kan haar helpen, ik schrijf de samenvatting en mail die, en we nemen afscheid.

Met de deurknop al in mijn hand besluit ik toch nog even terug te lopen. “Dat wat ik net zei he, over dat die pijn nog wel even kan blijven, dat is alleen bij dit specifieke probleem. Omdat die verstopping meestal niet in 1 x weggaat. Dus echt niet tegen je vriendinnen zeggen dat ze bij pijn gewoon even een weekje moeten doorbijten he’.

Ze schiet in de lach en belooft het.

Drie dagen later krijg ik een berichtje: blaartjes weg en ze voedt vrijwel pijnvrij. Zij blij ik blij.

Posted in Breastfeeding, Pijn | 1 reactie