Hello, wise ladies.



This is my first post, as I've wanted to respect the lactnet rule that this
forum is not intended for addressing personal issues.  Everything I've
encountered in 9 months of LLLL accreditation (and a year of leader
applicantship) has been easily answered by searches of the archives or other
readily available literature.



I've been following the tongue-tie discussion with great interest as many of
the potential sequelae of TT have been issues in breastfeeding and beyond
with my own three children.  Besides, in my work as a LLLL, I wasn't
entirely comfortable with giving information about tongue tie as I was in no
way sure I understood its presentation (God forbid a mother should ask my
opinion on her baby's oral anatomy!).



So after reading, recognizing some symptoms, and perusing a hundred or more
online images, I started looking in my family's mouths.



My 18-year-old daughter, who had early latch difficulties I'd always
attributed to positioning and early bottles (first child, accepted the
standard recommendations) and has minor articulation problems (tongue thrust
diagnosed at age 12, but not vigorously treated as we were told it was a
specialty SLP issue with a 6-8 month appointment wait, plus it responded to
at-home exercises and careful attention to mouth movement; words can sound
rather slurred when she speaks quickly) has three  bands tethering her
tongue to the floor of her mouth.  Using only online pictures as a guide,
I'd guess that it looks like a type 2 or 3 tongue tie, as she is able to
extend her tongue beyond her lips, and the frenulum is attached about 1"
behind the tip of her tongue.  I compared my own and the frenulum is
attached more like 1.5-2" back.  The frenulum (or three frenula?) does not
have a lot of play in it when she pushes on it with her finger.  She has
also needed extensive orthodontia and her teeth have moved back quite a bit
after completion of orthodontia.



The real clinker here is that her father has the same anatomy.  I have yet
to find an online image with a tongue attached by three bands.  My
ex-husband and his three brothers all have a characteristic speech pattern-I
and some friends call it "the K********* mumble" (I'll preserve the family's
anonymity)-that my son by this man also has.  I always attributed it to
laziness (mean, and yes, I feel guilty).  All affected family members are
able to articulate more clearly when they concentrate, presumably better
utilizing their limited range of motion.



I have not yet had an opportunity to look at my 14-year-old son's mouth.  We
had a very difficult breastfeeding history, with premature (28 week) birth,
borderline weight gain, and long-lasting thrush.  He did nurse until age 4,
but that may well be more due to my persistence than his ability.  He also
suffers from malocclusion and currently wears braces.



I'd love to hear from any lactnetteers who have seen this structural
anomaly.  How did it affect your patients?  What interventions were
considered or undertaken and what benefits or problems resulted?  Finally,
is there anyone in the Los Angeles area you'd recommend to assess
adolescent/adult tongue-tie issues?  I don't know that I (or my family) has
the energy to shop around with medical professionals who will just tell us
our concern is misplaced and bill.



Many thanks for your indulgence in addressing a personal issue.



Ellen Chase, LLLL


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