BBC article on tongue tie

[Saffron]

Services for babies with breastfeeding problems because of tongue tie need to be improved, a parenting charity says.

The condition, which restricts the movement of the tongue, can be treated with a simple procedure.

The NCT said services around the UK were too patchy, and more awareness was needed.

However, midwives' leaders said the procedure should only be done if feeding problems were definitely being caused as a result.

Read the rest here: http://www.bbc.co.uk/news/health-26199591

[Knomester]

Thanks for the link Saffron.

There was a short piece about this on Woman's Hour yesterday as well: http://www.bbc.co.uk/programmes/b03vdx7t

I'm really happy to see that there is more publicity around tongue ties and the potential implications for woman trying to breastfeed a tongue tied baby. I just hope that this filters down to GPs and HVs, some of whom were, in my experience, neither knowledgeable nor supportive.

We are however very lucky to have the expertise at King's close by as well as BF Cafes like the one in Peckham.

As I approach due date with baby number 2 I've been thinking about this a lot after the problems I had first time around - http://www.eastdulwichforum.co.uk/forum/read.php?29,570543 - and I will definitely go into hospital with the phone number of a private consultant to hand in case baby number 2 has a tongue tie like his/her big brother.

[cashewnut]

I can't understand why they don't just check all newborns babies when they're born? Surely it would take about 10 extra seconds for the doctor to take a quick look when they do the other checks, and save enormous amounts of grief for huge numbers of people?

Am I missing something?!

[Pickle]

When my son was loosing weight, feeding constantly, and I was at my wits end (7 years ago now) it was a student midwife that spotted he had a posterior tongue tie. Prior to that, we had been referred to the paeds team at Kings who didn't diagnose it, as well as a variety of senior midwives and other health professionals.

I wholeheartedly agree that a check should be done as standard, but think there needs to be a lot more education surrounding this given to the health professionals further up the food chain.

[Sonners]

I agree with Pickle that there definitely needs to be more training as well as checking the babies for tongue tie - I was told by three different midwives at King's that my daughter didn't have a tongue tie (which was eventually diagnosed at 8 weeks).

[Saffron]

cashewnut Wrote:

-------------------------------------------------------

> I can't understand why they don't just check all

> newborns babies when they're born? Surely it would

> take about 10 extra seconds for the doctor to take

> a quick look when they do the other checks, and

> save enormous amounts of grief for huge numbers of

> people?

>

> Am I missing something?!

It think the article touches briefly on this. Some babies appear to have a tongue tie, but they don't demonstrate any problems from it. So putting them through the stress of tongue tie release procedure would be unnecessary.

Whereas other babies look normal but display all the other symptoms of tongue tie such as poor latch, fussiness, wt loss etc. This can be posterior tongue tie, or another problem altogether. Needs specialist diagnosis.

So it's not just as simple as a dr checking Baby's mouth, which may be one reason it's not recognised and treated more efficiently. Xx

[fapl]

Best to know there is tongue tie though immediately after birth, if it doesn't cause problems and does not require treatment, great. Knowing can save weeks of heartache when nobody can explain to you why your baby can't feed/you can't breast feed. It will also save tens of thousands of women giving up breastfeeding in the early weeks when that is not what they want to do.

Saffron, if all babies are checked at birth and all midwives are trained to identify posterior ties (volunteers in the community are successfully trained to identify this problem so it shouldn't be specialist, it shold be standard training) as well as more standard and obvious ties, hopefully a lot less babies will be reach the point where they are referred to specialists for 'failure to thrive' and other feeding issues. I am sure a 10 second check by midwives will cost the NHS a lot less money in the long run than appointments for all these babies being otherwise being referred to specialists.

The article, 3% of babies affected! Where did they get that stat from?! It is loads more than that.

[buggie]

Agree that not all babies need treatment for tongue tie, but, if it's assessed early on then surely it'll reduce the stress/increase chances of successful breastfeeding in those babies who do need it released.

Especially having had problems br/feeding first time round (wasn't assessed for tongue tie but at 4mths HV thought she saw a posterior tie - disputed by MW's at br/feeding clinic).

Having worked on a HV team (not in this area) I've been disappointed by how little training/teaching on feeding probs is given to health professionals dealing with new mums/babies even doing the UNICEF breast feeding training only talked about the latch but no discussion of tongue tie/how to recognise it or what the pathway for care was.

[buggie]

fapl Wrote:

-------------------------------------------------------

> Best to know there is tongue tie though

> immediately after birth, if it doesn't cause

> problems and does not require treatment, great.

> Knowing can save weeks of heartache when nobody

> can explain to you why your baby can't feed/you

> can't breast feed. It will also save tens of

> thousands of women giving up breastfeeding in the

> early weeks when that is not what they want to do.

>

>

> Saffron, if all babies are checked at birth and

> all midwives are trained to identify posterior

> ties (volunteers in the community are successfully

> trained to identify this problem so it shouldn't

> be specialist, it shold be standard training) as

> well as more standard and obvious ties, hopefully

> a lot less babies will be reach the point where

> they are referred to specialists for 'failure to

> thrive' and other feeding issues. I am sure a 10

> second check by midwives will cost the NHS a lot

> less money in the long run than appointments for

> all these babies being otherwise being referred to

> specialists.

>

> The article, 3% of babies affected! Where did they

> get that stat from?! It is loads more than that.

Completely agreec(& prob far better put than my post!)

[fapl]

Also, feeding issues can hit the mental health of new mothers quite hard.

[Saffron]

fapl Wrote:

-------------------------------------------------------

> Best to know there is tongue tie though

> immediately after birth, if it doesn't cause

> problems and does not require treatment, great.

> Knowing can save weeks of heartache when nobody

> can explain to you why your baby can't feed/you

> can't breast feed. It will also save tens of

> thousands of women giving up breastfeeding in the

> early weeks when that is not what they want to do.

>

>

> Saffron, if all babies are checked at birth and

> all midwives are trained to identify posterior

> ties (volunteers in the community are successfully

> trained to identify this problem so it shouldn't

> be specialist, it shold be standard training) as

> well as more standard and obvious ties, hopefully

> a lot less babies will be reach the point where

> they are referred to specialists for 'failure to

> thrive' and other feeding issues. I am sure a 10

> second check by midwives will cost the NHS a lot

> less money in the long run than appointments for

> all these babies being otherwise being referred to

> specialists.

>

Sorry, fapl, I think you've misunderstood my post a little. I don't disagree with what you've written! Just because training is needed and/or not every examination results in a given outcome, I'm categorically not saying that more training and earlier systematic exams are not justified. Better training and earlier diagnosis is most certainly needed.

My response was specifically to a previous post, elaborating why a short visual exam is not necessarily diagnostic of tongue tie.

> The article, 3% of babies affected! Where did they

> get that stat from?! It is loads more than that.

Those are clinical stats. I can look up the journals when I next have the chance. From where do you get your different stats? Would be interesting to compare. Have often thought posterior tongue tie is underdiagnosed.

[Yak]

I had down on my birth plan that I would not be discharged until my LO was checked for tongue tie - talk about being paranoid!

[fapl]

A check for tongue tie is not just a visual check, it is a rubber glove on and a feel under the tongue, so I have missed something somewhere along the line, I assumed making a tongue tie check at birth would mean actually checking. Having a bit of a look would be the most pointless check as so many cases would be missed.

Saffron, if you want to read up on frenulums I can highly recommend the work of the late Dr Brian Palmer (he sadly committed suicide about 2 years ago). He was the first to admit his own personal research was not scientific in that it was compiled through his own work experience and research, not looking at big enough population groups etc. He was a dentist with no children of his own so no vested interests that I can see which to me makes him all the more amazing for producing his research.

[nicolajaneG]

My eldest daughter had a tongue tie, not spotted until 3 1/2 and was related to developing a lisp. Never any problems with feeding as a baby. At kings they explained that there are three levels of tongue tie and not all benefit from surgery. My daughter did have surgery and her mouth was scarred internally as a result. She ended up having 6 more operations and then a final operation to have two salivary glands removed as the scarring from the tongue tie op meant they could no longer drain. They would get so blocked they would swell and prevent her from eating and affected speech more than tongue tie ever did! Years of speech therapy, lots of time off school and years of discomfort for her. This maybe an isolated experience but be cautious.

[JayJay5]

It's such an interesting issue, isn't it? Especially with that fact that many babies with tongue ties don't seem negatively affected at all...

Do you know that Neighbourhood Midwives (who I work for) have just started a new Tongue Tie and Midwifery Chat clinic at the Vale therapy centre in East Dulwich every other Tuesday morning? A specialist midwife will properly assess your baby to see if they have an anterior or posterior tongue tie and will listen to you about exactly what breastfeeding issues there are... It costs ?15 to have the assessment and ?120 for the procedure should you need/want it, which can be done in your home if you'd rather

We're also there to chat about any pregnancy/birth/postnatal questions.

Good to have in the area...

[MichelleT]

My son had a tongue tie, which wasn't diagnosed til 10 weeks and not sorted for another month, by which time breast feeding just wasn't going to happen. I commented in hospital, when he was having difficulty latching on, that it might be worth checking for TT. I was ignored. I had pretty bad PND and was very upset by what I saw and felt as my failure to breastfeed. So much heartache could be spared for women beating themselves up over these issues if tongue tie checks were automatic.