Tongue tie obsession

mandr

Mon, May 29 2023, 9:19 am

I still don't see anyone pointing out any complications?

amother

Carnation

Mon, May 29 2023, 9:26 am

DS's tongue tie was taken care of as a baby by a dentist. Considering that a dentist specializes in the inside of a mouth I'd trust her opinion over the pediatrician.

amother

Maple

Mon, May 29 2023, 11:28 am

One of my friends had a lot of trouble nursing until her child had a tongue tie release, so I knew to look out for it with my first. I was proactive and asked the lactation consultants in the hospital to check, and they said it was fine. I then had terrible terrible trouble nursing, cracked nipples, horrible pain, etc, until I finally saw another LC who spotted the tongue tie and recommended a dentist experienced with tongue ties. After we had it released, no problems and BH are nursed a long time. So a second (or third) opinion is really helpful, and I will always recommend that to people. I don't think pediatricians are very knowledgeable about this and not all lactation consultants are either.

amother

Mon, May 29 2023, 11:41 am

mandr wrote:

I still don't see anyone pointing out any complications?

Some complications are bleeding or infection, or damage to the tongue or salivary glands. It's also possible to have scarring or for the frenulum to reattach to the base of the tongue

amother

Mon, May 29 2023, 11:46 am

This tiny area has become a large battleground for many practitioners and families. While emphasis and support of breastfeeding, especially in the early weeks and months of a newborn’s life is important, chalking up difficult breastfeeding to a tongue tie and/or lip tie may be a bit of a stretch, so to speak. There are, as yet, no standardized guidelines for this procedure, and many practitioners are concerned that it’s become an overused enterprise, feeding on the anxiety of new parents who are trying their best to feed their child. Dr. Brian Wiatrak, Clinical Professor of Otolaryngology at the University of Alabama and Co-Director of the Aerodigestive Program at The Children’s Hospital of Alabama, has been in practice for close to three decades. He has some serious concerns about the increase in numbers of this procedure being performed. He notes that tongue tie release surgery “can play an important role for babies who have significant problems with breastfeeding when they have a physical examination that clearly demonstrates tethering and restriction of tongue mobility.” Further, Dr. Wiatrak states that “other types [of procedures] such as lip tie...have been treated with...lasers...which may cause complications such as [oral burns] and excessive scarring.”

Dr. Wiatrak mentions that there continues to be ongoing questions about the necessity of this procedure, as well as those involving lip ties, without clear indications or physical abnormalities deeming an infant a surgical candidate.

A recent study published in JAMA Otolaryngology-Head and Neck Surgery investigated a group of infants referred to an otolaryngology practice for tongue tie release surgery, aiming to assess how many of these procedures are actually necessary, and whether or not there are alternative options. The study, based at the Massachusetts Eye and Ear Infirmary and the Massachusetts General Hospital, both in Boston, looked at over 100 babies referred to an otolaryngology surgeon for surgical repair of a tongue tie. The average patient age was 34 days old. All patients were enrolled in a multidisciplinary feeding evaluation by speech and language pathologists. Prior to going ahead with surgery, families were offered techniques to improve quality of breastfeeding. Following this program, over 60% of infants referred for surgery of the tongue or lip fold did not need it.

This finding underscores the importance of recognizing that infants have many reasons to have challenges with feeding, and, while surgery of a tethered tongue and/or lip may, indeed, relieve this difficulty, in more than half the cases, it may not be necessary. Many practitioners, including dentists, oral surgeons,and otolaryngologists, offer in-office laser procedures for tongue and lip ties. While, for the most part, these procedures are safe and effective, they are not without risk. And they may not be necessary at all. ( Taken from Forbes)

mandr

Mon, May 29 2023, 12:08 pm

amother OP wrote:

Some complications are bleeding or infection, or damage to the tongue or salivary glands. It's also possible to have scarring or for the frenulum to reattach to the base of the tongue

bleeding or infection - that's standard with anything. Even a bloodtest.

damage to the tongue or salivary glands - do you know anyone who actually had this issue?

frenulum to reattach - if that's actually a bad thing, then it being attached to begin with is also bad, right?

amother

Lightcoral

Mon, May 29 2023, 1:30 pm

amother OP wrote:

These doctors are only looking at tongue ties in relation to breastfeeding. Like I said earlier, we are dealing with a whole host of issues with ds11 that could have been prevented or at least lessened had we taken care of his tongue tie earlier. Because of the tongue tie, his tongue doesn’t sit comfortably in the roof of his mouth, which is where the tongue should be when your mouth is closed. So he keeps his mouth open, which affected the whole bone structure of his jaw as he grew. He has an extremely narrow palette, which is now being corrected with an expander and braces. If I had known about this earlier, we could have corrected the tongue tie and a SLP could have worked with him to keep his mouth closed and breathe through his nose. Correcting it at this age is much harder.

Bottom line, tongue tie doesn’t only affect people as babies. It’s not only in relation to breastfeeding. Like I said, my son nursed well. But unfortunately this is all something I’ve only learned recently.

amother

NeonPink

Mon, May 29 2023, 2:56 pm

I had a child who wasn’t making any sounds at 12 months. Child had severe tongue tie and couldn’t move the tongue. Feeding solids took an hour for a little baby jar. Nursing had been painful but the hospital and our pediatrician all said there are no ties.

I had another baby that nursing was taking too much time and Baby would fall asleep and wake up after a short time hungry again. We clipped the tie and Baby nursed more efficiently. It took much less time and baby got more in each feeding and didn’t need to be eating non stop.

I have feeding issues for a child who never had it clipped and is already a teen. It was before we even knew about it. Another had speech delays until it was snipped and needed several years speech Thea to catch up.

amother

Cadetblue

Mon, May 29 2023, 3:03 pm

honey36 wrote:

I think it is very common, and that's why people are skeptical about it. Like, how can it be that soooo many babies need the release.

People don't realize this is not a new thing or a "fad". I've heard stories that in the "old days" the midwives all had one very long thumbnail so they could cut the babies tongues at birth. (sounds like the kohanim right Smile

)

In addition, I think more issues are cropping up because of other related lifestyle changes, not because of the tie itself. For example, some changes in more recent years:
babies are not nursed as much or for as long
More pacifier/bottle use
The invention of sippy cups- teaches kids the wrong way to swallow
Processed foods- much softer and don't need as much chewing (think crackers vs raw veggies like celery carrot)
More mouth breathing due to more pollution/asthma/food allergies/seasonal allergies

All these factors are related to tongue-ties. So for example- if you have a baby with a tongue tie, but they breastfeed until 2 years, eat lots of chewy food, only drink from open cups, never have a pacifier, and are good nasal breathes, the tongue tie issue will likely resolve itself because all these activities help promote good swallowing and tongue position. This also helps "stretch out" the tongue tie so it doesn't need to be cut. This is not true ALL the time, but somewhat explains why the ties are causing more issues than they did years ago.

MTHFR and methylation issues causing an increase in midline defects may be another piece.

amother

Indigo

Mon, May 29 2023, 3:19 pm

amother OP wrote:

What’s with the tongue tie obsession? Any time an op mentions a baby posters will think that’s the problem. Even if a baby is tongue tied it’s not necessary to do anything about it unless it severely impacts feeding. The procedure is an overdone one.
Tongue tie and pandas is always the source of all problems ( and you need a “literate” provider as doctors don’t know anything about these two issues Banging head

Tell me you've never been in this situation... or had to deal with it... or struggled with a child while all the professionals said there's nothing wrong... or spent hours researching and self advocating.... spent thousands of dollars out of pocket...

....without telling me

amother

Smokey

Mon, May 29 2023, 4:13 pm

People who found out later when issues like adult-onset TMJ pain happened to them that a simple procedure could have fixed their problem in infanthood are rightfully upset.

amother

Camellia

Mon, May 29 2023, 4:19 pm

My very experienced pediatrician told me that he sees many more tongue ties nowadays than he used to decades ago. He speculated that it could be related to increased folic acid intake, which prevents spina bifida but possibly would affect the “center seam” relating to tongue ties. Thought that was interesting, would have no idea if it has any basis.

amother

Turquoise

Tue, May 30 2023, 3:59 am

amother Camellia wrote:

Check this out:
https://pubmed.ncbi.nlm.nih.gov/31835174/

More studies are needed but folic acid may be a part of the picture