I am equally intrigued by this topic. My son was tongue-tied and still is and managed to breastfeed despite the tongue tie... however, i guess he would be considered mild as he has good speech and is able to lick his lips... i do read the posts by Palmer and others though and wonder if my son is facing long term health challenges b/c of his tongue tie...
i have so many questions about it... is do we know what causes TT? on wikipedia it says that in one study cocaine users had a higher incidence... however, suspect the study is it does get one thinking about the causes... and i'm wondering if there's anyone doing research on this..? as we learn more about it and how it affects a baby's ability to nurse as well as long term effects on health and living it seems like this isn't such a innocuous defect... and i would be interested in learning more... if anyone knows a good resource I'd love to know..
i've worked with several TT babes both pre and post op and i'll tell you ... these nursing couples go through a loT!
rgds
georgia
------------------------------
Date: Thu, 20 Nov 2008 10:03:53 -0500
From: [log in to unmask]
Subject: regression after TT
Jen,
I have worked with approx 100 babies with posterior TT in the past 2 years. There are only 2 docs in my area
who clip and one of them is Betty Coryllos, the other was trained by her. So, we get really good results. I have
personally attended at least half of the clippings and I send 100% of my babies for CST with a chiropractor. The
chiro and I have worked closely with Betty to evaluate how often we need reclippings and how much regression
we are seeing. We have observed that since we have been using certain techniques with the babies, we are
seeing that the babies who need second clippings are getting better results than before and that almost none
need a third anymore. IMO, ignoring the structural work is ignoring the really important part of the treatment.
While the structural work cannot solve the problem without the clipping, the clipping cannot restore full function
w/o the structural work. We have one baby who would probably benefit from a z-plasty, but she has had so much
structural work now that we are going to see if reclipping will suffice. It is those babies will anatomically short
tongues who really might need z-plasty, b/c releasing the frenulum cannot make the tongue longer.
I think every LC needs to make it a priority to find a really good structural therapist in their area, attend sessions,
become educated and use the services. I teach a conference session called "Optimizing Human Potential Through
Normalizing Function" and the foundation of my presentation is that normal function can only be achieved
though normal feeding. So much of what we see in babies is compensatory and does not support the best
functional development. Babies do not outgrow poor function--they integrate it. When you have to direct energy
toward compensation, that energy is not available for development.
ennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC
Cahyn,
I was just looking through the archives and I don't know if anyone responded to your
post.
I posted awhile back about a son of mine who was tongue-tied who I could not find a
provider 16 years ago willing to clip for breastfeeding, and then later for speech issues,
who subsequently developed a large tongue, sleep apnea, and bed wetting.
I believe the bed-wetting came from the sleep apnea which I believe was caused by the
large tongue, and I think the large tongue developed as a result of having to work too
hard to move because it was extremely anchored to the floor of the mouth.
I came to this conclusion after watching a lecture by Brian Palmer DDS. I am not sure if
Brian Palmer is as sure as I am about his own theory- of a large tongue developing as a
result on extreme tongue-tie, but I have a large enough family that I believe if the large
tongue was just the result of genetics somebody else would have one, and no-one else's
tongue even comes close- the tongue is freakishly big.
The only other family member with an extremely large tongue is not in our immediate
family, and he too is extremely tongue-tied and has snoring and even snorting issues in
the daytime from an obstructed airway.
About 6 months ago I finally talked a provider into giving my son a frenectomy. My son
was so tongue-tied he could not clean food out of his vestibules with his tongue like
everyone else (the pockets between the cheek and gums) and he was also asking for a
frenotomy because...well, because, he is a teenage boy....
The oral surgeon was very skeptical that it needed to be done but once he got into the
surgery he did a lot more lasering/cutting than he had planned, and he was positively
gleeful in describing the surgery to me afterward because he knew it was going to change
my son's life.
My son had a frenectomy with a surgical revision but only a few stitches.
My son did notice an immediate improvement in mobility- he described his tongue as
feeling "light" before the anesthesia had even worn off...BUT the scar tissue he has
developed overtime has lead to a regression.
I think what he needs is a z-plasty...more of a surgical revision so that the tongue is
lifted off the floor of the mouth further back and he is sutured extensively so that the
improvement is permanent.
This problem is vexing me professionally as well because I have a client with a 3 month
old who has had a simply frenotomy with no improvement. The baby has an older sibling
who had a swallowing disorder that was treated with a z-plasty.
I think if moms see an immediate and permanent improvement with breastfeeding after a
simple incision of the frenulum, or an small excision of the frenulum with modest
revision- just a few stiches- their babies had mild to moderate tongue-tie and their babies
got the surgery that matched their condition.
I think in cases where there is obviously a tongue-tie but the simple frenotomy or
frenectomy provides no relief to the mother or there is a regression, the baby is
extremely tongue-tied and is really in need of a z-plasty.
So my question is are z-plasties ever done on babies?
Are there problems with breast refusal after the surgery?
(my son said his surgery while not as extensive as z-plasty was extremely painful and he
did not know how a younger child or baby could cope with it)
If the baby is going to develop swallowing issues later does it make sense to take the risk
with anesthesia and pain in the young baby with the hopes of improving breastfeeding
because the baby is going to need the surgery in a matter of months anyway when solids
are introduced?
Anyway I am still in the information gathering stage of forming my opinions about the
subject, and I have my leanings, but I would like to hear from other lactnetters about
their personal and professional experiences with frenotomy, frenectomy and z-plasty,
so I can help my client with the extremely tongue-tied baby.
Jennifer O'Quinn IBCLC
?
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