Permission to post.

I am attempting to find information associating tongue-tie with these conditions.  It makes sense but I haven't found anything to back up my suspicions.  I am assessing this mom and baby for the first time at 11 months because mom discovered a lip-tie and has concerns about oral development.

Mom had severe polyhydramnios which required fluid removal with amnio.  Baby also had repeated ear infections.  Baby is 11 months old now and I am not seeing any significant swallowing difficulty, at this time (no noisy air swallowing, choking or difficulties with solids) and I am wondering if baby could have had enough trouble swallowing in utero, to have such severe polyhydramnios?

Also, I have never seen a tongue restriction with such a long tongue.  Baby loves to stick out tongue and the tongue is visible during nursing, wrapped around the nipple.  It moves a lot when baby suckles.  This baby also has the most shallow latch I have ever seen.  Baby's mouth is nearly closed and baby feeds on the nipple and avoids a deeper latch.  Mom is knowledgeable and knows how to achieve a deep latch but baby refuses.  Baby pulls hard on the nipple while suckling and the nipple slides in and out of baby's mouth.  Baby has to work very hard to hang on.  We did a before and after weight with an appropriate scale and baby transferred only 1 ounce during what seemed like a typical feed.  Mom's nipples are significantly compressed after feeds and feeding is not comfortable.  Baby also has a high, narrow, bubble palate and a sensitive gag.  Weight gain has been slow; baby is in 17th percentile and was over the 50th at birth.  Mom reports that baby loves solids and does fine with them.

Baby is happy, social, active and meeting milestones.   Baby didn't cry much at our consult so I couldn't see if baby would raise the tongue when crying full out.  Baby's tongue did retract when yawning.  Do yawns work for evaluating tongue function or does everyone retract the tongue when yawning?

Baby's lingual frenulum is thick and white and palpably tight and attaches at the very back of the tongue.  This is a restriction that is not easy to evaluate due to the longer tongue.  Baby aslo has a thick labial tie that attaches at the gum-line. 

Does any of this sound familiar to anyone?

Laura Spitzfaden, LLLL, IBCLC

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