I was recently interviewed by Sheila Coles from the Morning Edition on CBC Regina. We were discussing tongue ties, laser revision and new supports coming to Regina.
Here is a link for anyone wanting to have a listen
http://www.cbc.ca/morningedition/episode/2013/02/14/help-for-tongue-tied-babies/
Some of what was higlighted in the six minute discussion I have summed up below plus expanded a small amount for clarity.
The
definition of (tongue or lip) tie is restricted mobility as a result of a short
and/or tight frenulum. Restricted mobility impacts the function of the tongue. (And the tongue is a key player in breastfeeding).
The
definition of a tie is a functional one used in conjunction with visual
assessment. Using only appearance qualities to make a diagnosis causes
professionals to miss some ties but could also lead to over-treatment.
Visual
assessment alone is not adequate for diagnosis and treatment decisions. The
evaluation of function must take precedence over appearance so that over
treatment can be avoided. Depending on symptoms will depend on who you may need
to help make an assessment. (Lactation consultant, dentist, speech pathologist, chiropractor, osteopath,etc) It can be a interdisciplinary approach from assessment to treatment.
2-12%
of the population are said to be affected by ties depending on the population
under study and the definition used. There are various grades of ties identified which can impact symptoms, diagnosis and treatment. The current lack of awareness and education are often barriers to assessment & treatment.
Like
everything in medicine advancements are made. Lasers have now provided us
advancement in treatment of oral restrictions with benefits over scissor
releases.
Scissors
bleed, can be messy, cannot always reach all ties efficiently and have more of a one-time chance. Lasers do not bleed,
user has more control, practioner can get back further to ensure a deep enough release and
can assess as the procedure is being done. Lasers also have anesthetic
properties as well as antibacterial properties.
Symptoms
can be maternal and/or baby: maternal pain, nipple damage, engorgement,
mastitis, thrush, low milk supply, weight loss in baby, slow weight gain in
baby, failure to thrive babies, reflux, colic, digestion issues, fatigue, slow
feeds, difficulty latching, gagging, choking, coughing, breast refusal, shallow
latch, chin tremors, clicking noises, fretful
Breastfeeding
Impact
• Inadequate latch that interferes with
milk transfer
• Insufficient milk intake and
inefficient feeding due to inability to maintain and adequate tongue seal
• Nipple/breast pain and damage
• Compromised normal
suck-swallow-breathe patterns
• Long feeds
• Possible weight gain compromise
• Reduced milk supply
• Early weaning
• Need to supplement
Beyond
breastfeeding
• Bottle-fed baby can also struggle
• Babies may have trouble with solid
foods (reverse swallowing)
• Speech may be affected
• Orofacial development (high, narrow
palate, orthodontics)
• Dental issues
• Increased salivation
• Airway integrity and apnea
Feeding and
milk supply concerns can be worked on with the assistance of a Lactation
Consultant. There are various tools and management techniques that can be used
depending on each unique situation.
Tongue
mobility is the goal of laser treatment. The secondary results, such as
increased milk transfer occur only when treatment restores optimal tongue
placement, movement and strength.
Function
restoral is generally dependent on a team approach to care including dentists,
bodyworkers (osteopathy, chiropractic) and lactation consultants.
When
breastfeeding is the concern the earlier the treatment the better but that is
not to say later treatment is not beneficial to other symptoms that may arise.
Tongue ties
are a controversial and subjective topic currently.
The team approach will be growing in Regina soon with a local dentist coming on board to help with treatment.
The team approach will be growing in Regina soon with a local dentist coming on board to help with treatment.
1 comment:
I used to live in Regina, so I know of you from my time there. This is interesting, as my first born was SEVERELY tongue-tied. He was born over 3 years ago in Winnipeg and we had to take him to a pediatric dentist on day 2 since they don't cut the frenulum in the hospital. We learned to breastfeed with a shield and then after 2 weeks moved directly to the breast. We were successful for 4 months, and then sadly as a first-time mom I gave up (other issues were present, such as a lactose allergy and colic). We flew to Toronto to visit with Jack Newman two times about this, and had the tongue cut again. I do agree that the laser technique may be a great advancement, since it grew back ever time it was cut by scissors, and it was horribly traumatic for myself and my son at the time. Jack Newman commented he had never seen a tongue-tie so severe in all his years of practice. However, my son had great weight-gain throughout the 4 months of breastfeeding (90th percentile) and it was probably my insecurities that lead to early weaning. I do think the breastfeeding allowed him to stretch the frenulum, as he is now 3 and has no issues with his speech, etc. Great article since there was nothing on the internet like this when I was searching for resources at the time. Thanks.
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