Uploaded by Angela Kavallieratos

Tongue Ties

Tongue Ties
To Cut or not to Cut? 082 674 2770 Dr Gershun
Mostly genetic
Some with facial-related syndromes
Mostly in males
Some are non-symptomatic, therefore base it on the mom.
Feeding problems
Later food clearing
Speech: l/r/th/s
How do they present
Cracked, bleeding nipples
Breast pain
Lipstick shaped nipples
Clicking of the tongue (baby has to suck and pull the nipple in and out, if tongue is too short,
will slip and tear/wear nipple away
Baby will bite with the gum
If the above 2 fail – baby will get lips involved
Mom is exhausted and baby is tired and aggravated
Baby’s Symptoms
Restricted tongue movement
Poor weight
Dribbling during feeds
Long/frequent feeds
Difficulty staying latched
Small gape resulting in biting/grinding behaviour
Unsettled behaviours
Reflux: thinken feeds/keep baby upright for 45min after
Development of the Tongue – NB
Frenulum – joining of left and right – natural join
Under ¾ months – don’t risk GA
Some are membranous, some vascular, some muscle – range in thickness
Cannot stretch a tongue-tie
Find that the nipples will change not the baby’s tongue/tongue tie
Posterior tongue tie – hardest to find
Cracked nipples
Problems latching
1 – short tongue tie – close to the base
2 – almost half-way
3 – almost at the tip
4 – at the tip
[heart-shaped tongue] [abraded/cut tongue tie] [blanching of tongue]
Frenotomy / Frenectomy
Baby must be relaxed (milk-drunk or use sucrose)
Local anaesthetic – baby can feed later in the day
Failure of procedure
Reattachment (recommend exercises and massage – wound does go yellow)
Infection is very rare
Association of tongue-tie practitioners
IATP – international association of tongue tie professionals