Tongue Tie

[Guest guest]

I have actually found for purposes of helping parents and professionals understand that the list of possible issues, "Presentation of Tongue Tie" on Pg. 3 of CWG's and Dr. E. Coryllos' AAP article is the most thorough list of things to look for.

In her chapter on Tongue tie (hidden), Chapter 9, Dr. Betty spends two pages explaining that it is the impaired function of breastfeeding that should be looked at more closely than the appearance of the tongue.

Can't latch

If latches, causes pain

If no pain, can't transfer sufficient milk

and the one that is universal, the ultimate sign for me: falls asleep within minutes of initiating feeding at breast and sometimes at bottle or feeding device where the baby has to move the milk him/herself.

I agree with Dee on the unbalanced/tight muscle issue. I have now started referring more babies who present with tight necks (cause more pain on one breast than another or can't stay flat on back with hips and shoulders in contact with surface) or tight jaws (can't drop their jaw very far when crying) immediately for CST instead of a scissors clipping.

One of the reasons is that even with an appropriate and successful surgery to release the fibrous bands, the therapy afterward (suck training exercises and/or CST) has not all been successful for many of the babies recently. This is driving me crazy. And I am finding a significant number of babies that require a 2nd clipping, due to a T4 behind a T3 or scarring down of the original clipping, that we just can't get back to breast. It all seems to be too much for them. Most parents have abandoned any form of supplementing at the breast or finger feeding. The bottle is easier for them and the baby and that is frequently the death knell of at-breast feeding.

I have also started offering the option of CST instead of a 2nd clipping to parents whose babies still had a restriction post-frenotomy. Those who were very negative toward CST as an initial way to resolve a TT are much more open to CST after going through the trauma of the first frenotomy. I have had a small number exercise this option successfully. It is wonderful and joyful when it works.

As far as the Hazelbaker Assessment Tool I don't use much if any of the appearance items but use the function items almost exclusively. But the big thing the examiner has to do is a sublingual sweep!! You can feel it and if you use a flashlight, you can show the TT to the parents when the baby is crying.

Ann One site keeps you connected to all your email: AOL Mail, Gmail, and Yahoo Mail. Try it now.