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Date: | Wed, 23 Sep 2009 13:38:36 -0400 |
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Pierre Robin sequence is a very very short jaw (micrognathia) that is
placed far back, which causes the tongue to be placed far back in the
mouth (retroplaced tongue), which occludes the palate and does not allow
it to close (U-shaped cleft palate). It is now called a sequence rather
than a syndrome because it is recognized that the first defect (the
extreme micrognathia) causes the others.
Doctors differ on whether a baby can be diagnosed with Pierre Robin
sequence when there is no cleft palate. The major difficulty in Pierre
Robin is that the tongue falls into the airway and blocks it, so
breathing and feeding are very difficult. If there is also an overt
cleft palate, the baby will be unable to create negative pressure in the
mouth.
The baby you are seeing, Julie, seems to have both a tight lingual
frenulum and a tight superior labial frenulum, along with natal teeth.
Diane Wiessinger was the first to publish that there could be an
association between tongue tie and tight labial frenulum. When the baby
also has a short jaw, feeding can be very difficult.
Catherine Watson Genna, BS, IBCLC NYC
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